DR. MICHAEL CROCKETT PSYD
NPI 1780074807
Psychologist in Gresham, OR

Active since January 27, 2015PECOS EnrolledAccepts Medicare Assignment
4316 SE 182ND AVE, GRESHAM, OR 97030(503) 893-2249 Get Directions Write a Review

NPPES record last updated: March 2, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Michael Crockett Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MICHAEL CROCKETT PSYD (NPI 1780074807) is an individual psychologist in Gresham, Oregon and active in the NPI registry since January 2015. He is enrolled in Medicare PECOS and is a graduate of Other (2014).

NPPES Registry Identity

NPI1780074807
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. MICHAEL CROCKETTCredential: PSYD
Location Address4316 SE 182ND AVEGresham, OR 97030-5058
Mailing Address2315 Ne Francis CtGresham, OR 97030-3155 · (302) 270-8286
Sole ProprietorYes
Medical School CMSOtherGraduated 2014
Enumeration DateJanuary 27, 2015
Last NPPES UpdateMarch 2, 2022
NPPES CertifiedMarch 2, 2022
NPI 1780074807 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · Cognitive & BehavioralTaxonomy 103TB0200X
Also ListedPsychologist · CounselingTaxonomy 103TC1900X
Also ListedPsychologist · Group PsychotherapyTaxonomy 103TP2701X
4316 SE 182ND AVE, Gresham, OR 97030

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dr. Michael Crockett Psyd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759776131
PECOS Enrollment IDI20220322000917
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
4316 SE 182ND AVE
GRESHAM, OR 97030

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Crockett's NPI number?

The NPI number for Michael Crockett is 1780074807. It was assigned to this individual provider in the NPPES registry on January 27, 2015.

Where is Michael Crockett located?

Michael Crockett practices at 4316 SE 182nd Ave, Gresham, OR 97030. The listed phone number is (503) 893-2249.

What is Michael Crockett's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Michael Crockett enrolled in Medicare?

Yes. Michael Crockett is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Michael Crockett accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Regence BlueCross BlueShield of Oregon list Michael Crockett as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Michael Crockett was last updated on March 2, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.