DR. CHRISTIIAN STORM CREDLE (PSYD) – Psychologist, NPI 1316552102

DR. CHRISTIIAN STORM CREDLE (PSYD) is a healthcare provider. based in Philadelphia, Pennsylvania. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. PS019097 (PA). The NPI Number for DR. CHRISTIIAN STORM CREDLE (PSYD) is 1316552102

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHRISTIIAN STORM CREDLE (PSYD)
NPI
1316552102
Phone
(732) 395-3900
Address
1728 S 18TH ST
Enumeration Date
9 September 2020
Last Update Date
9 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2155630652
Graduation Year
2019 (7 years ago)
PAC ID
0547671877
Group Practice PAC ID
8527043736
Professional Enrollment ID
I20201118000142
Address ID
PA191471810PH1348XSTXX300

Contacts

Secure Messaging
christiiancredle@aidscaregroup.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

1,669 CLINICAL PSYCHOLOGIST in PA

Provider Addresses for DR. CHRISTIIAN STORM CREDLE (PSYD)

  • 1728 S 18TH ST

    PHILADELPHIA, PA 191452103

    Phone: (732) 395-3900

    Type: Mailing

  • 907 CHESTER PIKE

    SHARON HILL, PA 190791411

    Phone: (610) 583-1177

    Fax: (610) 583-1177

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-11-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20201118000142IClinical PsychologistPATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19145)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527043736View full group profile
NameSpecialtyState
Clinical Social WorkerPA
Family PracticePA
Internal MedicinePA
Infectious DiseasePA
General PracticePA
-PA
Internal Medicine, Infectious DiseasePA
-PA
Family PracticePA
-PA

Reviews

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Frequently asked questions

What federal number belongs to DR. CHRISTIIAN STORM CREDLE (PSYD)?
The federal identifier for DR. CHRISTIIAN STORM CREDLE (PSYD) is NPI 1316552102.
Does this profile mean DR. CHRISTIIAN STORM CREDLE (PSYD) is currently active?
Yes — DR. CHRISTIIAN STORM CREDLE (PSYD) appears active in the national provider directory.
What field does DR. CHRISTIIAN STORM CREDLE (PSYD) work in?
You can think of DR. CHRISTIIAN STORM CREDLE (PSYD) as practicing within Psychologist. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. CHRISTIIAN STORM CREDLE (PSYD)?
The page summarizes Philadelphia, Pennsylvania for DR. CHRISTIIAN STORM CREDLE (PSYD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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