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General NPI Number Information
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NPI Number | 1902292725
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Entity Type | Organization
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Legal Business Name | KRISTI VAN SICKLE, PSYD, LLC
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 10/04/2026
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Provider Practice Location Address
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Address Line | 111 2ND AVE NE STE 538
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3493
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Country | US
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Telephone | 727-586-5192
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Fax |
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Provider Business Mailing Address
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Address Line | 111 2ND AVE NE STE 538
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-3493
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Country | US
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Telephone | 727-586-5192
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | KRISTI SANDS VAN SICKLE
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Credential | PSYD
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Telephone | 727-592-5186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | PY7640
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License Number State | FL
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