CHRISTOPHER SLACK (PHD) – Counseling Psychologist, NPI 1407593221

CHRISTOPHER SLACK (PHD) is a healthcare provider. based in Grapevine, Texas. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 38821 (TX). The NPI Number for CHRISTOPHER SLACK (PHD) is 1407593221

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
CHRISTOPHER SLACK (PHD)
NPI
1407593221
Phone
(817) 329-5041
Address
1135 S MAIN ST
Enumeration Date
13 May 2022
Last Update Date
13 May 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8173295041
Graduation Year
2020 (6 years ago)
PAC ID
2567843170
Group Practice PAC ID
3971922717
Professional Enrollment ID
I20220713003254
Address ID
TX760517533GR1135XSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

1,347 CLINICAL PSYCHOLOGIST in TX

Provider Addresses for CHRISTOPHER SLACK (PHD)

  • 1135 S MAIN ST

    GRAPEVINE, TX 760517533

    Phone: (817) 329-5041

    Mailing address matches the actual address.

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: 2022-07-13

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
I20220713003254IClinical PsychologistTXTBD

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 76051)

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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: 3971922717View full group profile
NameSpecialtyState
Mental Health CounselorTX
Clinical PsychologistTX
Clinical PsychologistTX

Reviews

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Frequently asked questions

What is CHRISTOPHER SLACK (PHD)'s NPI number?
CHRISTOPHER SLACK (PHD)'s NPI is 1407593221 — the number used across U.S. healthcare to identify this provider.
Is CHRISTOPHER SLACK (PHD) shown as active in public data?
Registry records indicate CHRISTOPHER SLACK (PHD) maintains an active NPI.
What clinical focus is listed for CHRISTOPHER SLACK (PHD)?
At a glance, CHRISTOPHER SLACK (PHD) is tied to Counseling Psychologist. Clinical services aligned with this taxonomy classification.
What locale is associated with CHRISTOPHER SLACK (PHD)?
Directory geography for CHRISTOPHER SLACK (PHD) centers on Grapevine, Texas.
When was this NPI issued?
Enumeration for CHRISTOPHER SLACK (PHD) is noted as May 13, 2022 where the registry provides it.

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