Michael Crockett, PSYD
NPI 1780074807ActiveIndividual· Psychologist· Gresham, OR
Psychologist (PSYD) in Gresham, Oregon, with an NPI issued in January 2015. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1780074807 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | Yes |
| NPI issued | Jan 27, 2015 |
| Last updated in NPPES | Mar 2, 2022 |
| Certified by provider | Mar 2, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Psychologist, Cognitive & Behavioral | 103TB0200X | — | — |
| Psychologist, Counseling | 103TC1900X | — | — |
| Psychologist, Group Psychotherapy | 103TP2701X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (OR) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Clinical Psychologist |
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