SPRINGFIELD PSYCHOLOGICAL CENTER, LLC (NPI# 1174749881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174749881 |
| Entity Type | Organization |
| Organization Name | SPRINGFIELD PSYCHOLOGICAL CENTER, LLC |
| Practice Address |
2325 W White Oaks Dr Suite C Springfield IL 62704-7419 |
| Practice Telephone | 2177933949 |
| Practice Fax Number | 2177933995 |
| Mailing Telephone | 2177933949 |
| Mailing Fax Number | 2177933995 |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2017-01-12 |
| Authorized Official Name | DR. MELISSA FISHER PAONI (PARTNER) |
| Authorized Official Telephone | 2177933949 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071003515 | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071002838 | IL | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
071005516 | IL | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
149008476 | IL | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071006429 | IL | Behavioral Health & Social Service Providers |
| Street Address |
2325 W WHITE OAKS DR SUITE C |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62704-7419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770521247 | Melissa Fisher Paoni | Psychologist | 2325 W White Oaks Dr, Suite C, Springfield, IL 62704-7419 | 2006-06-04 |
| 1063885580 | William Mckenzie | Counselor | 2325 W White Oaks Dr, Springfield, IL 62704-7419 | 2015-11-05 |
| 1922108885 | Loretta Kay Mckenzie | Psychologist | 2325 W White Oaks Dr, Suite C, Springfield, IL 62704-7419 | 2006-09-22 |
| 1023121282 | David Stanley Brown | Social Worker | 2325 W White Oaks Dr, Springfield, IL 62704-7419 | 2006-08-15 |
| 1396772075 | Rachell Nichols Anderson | Psychologist | 2325 W White Oaks Dr, Springfield, IL 62704-7419 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902394901 | Hillary Haaker | Occupational Therapist | 2035 W Iles, Suite C, Springfield, ID 62704 | 2018-04-25 |
| 1871095364 | Edward Doyle Slifer Sr. | Pathology | 2117 Greenside Drive, Spring Field, IL 62704 | 2018-03-01 |
| 1598263345 | Santarelli & Feller Dental Group | Dentist | 1140 Rickard Road, Suite B, Springfield, IL 62704 | 2018-01-26 |
| 1447774757 | Lisa Ann Rogers | Developmental Therapist | 2101 Lexington Dr, Apt 3, Springfield, IL 62704 | 2017-07-28 |
| 1730611286 | Mindi Rowe | Occupational Therapist | 2508 County Rd 4 1/2 E, Springfield, IL 62704 | 2017-04-03 |
| 1366992208 | Jayme Jordan | Contractor | 2409 Westchester Blvd, Springfield, IL 62704 | 2016-10-04 |
| 1154793974 | Dina Payne | Social Worker | 917 Clocktower Drive, Suite 600, Springfield, IL 62704 | 2015-10-21 |
| 1770959819 | James R Reynolds | Hearing Instrument Specialist | 2347 W Monroe St, Springfield, IL 62704 | 2015-08-12 |
| 1336576495 | Emily Jane Dungey | Counselor | 920 S Spring St Ste 1300, Springfield, IL 62704 | 2013-10-03 |
| 1942552161 | Jeannie Marie Hundley | Specialist/Technologist, Other | 2921 Monvale Drive, Springfield, IL 62704 | 2012-10-11 |
| Find all providers in zip 62704 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
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| 1215556386 | Lotus Healing Center LLC | Psychologist | 28 Millburn Ave Ste 6, Springfield, NJ 07081-1023 | 2020-04-09 |
| 1194359216 | Kathrin A Koehler | Psychologist | 4674 Hominy Ridge Rd, Springfield, OH 45502-8031 | 2020-02-27 |
| 1689126120 | Assessment Consultants, LLC | Psychologist | 2146 W Chesterfield Blvd Ste E202, Springfield, MO 65807-8650 | 2016-11-01 |
| 1003366436 | Caitriona Hayes | Psychologist | 8134 Old Keene Mill Road, Suite 101, Springfield, VA 22152 | 2016-10-10 |
| 1669929907 | Richart Lipe Demier | Psychologist | 5871 S Northern Ridge Rd, Springfield, MO 65810-1976 | 2016-09-03 |
| 1043660905 | Safe Harbor Christian Counseling of Northern Virginia LLC | Psychologist | 8304 Old Keene Mill Rd, Springfield, VA 22152-1640 | 2016-06-21 |
| 1659786432 | Kimberly Wilkins Psyd LLC | Psychologist | 1344 W Oakville Rd, Springfield, MO 65810-1696 | 2014-06-30 |
| 1548507817 | Bahn and Associates | Psychologist | 3000 Professional Dr Ste D, Bahn Consulting, Inc., Springfield, IL 62703-5931 | 2013-01-07 |
| 1396004990 | Cultivate Psychological Services LLC | Psychologist | 1439 S Rogers Ave, Springfield, MO 65804-1129 | 2012-05-16 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62704 |
Please comment or provide details below to improve the information on SPRINGFIELD PSYCHOLOGICAL CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.