Provider Demographics
NPI:1346045507
Name:CRICHLOW-BALL, CAROLINE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:CRICHLOW-BALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:PAYNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3571 FAR WEST BLVD UNIT 3542
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3064
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3571 FAR WEST BLVD UNIT 3542
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3064
Practice Address - Country:US
Practice Address - Phone:512-589-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810008543103TC0700X
NMPSY-2024-0084103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist