PSYCHOLOGICAL SERVICES OF CENTRAL ILLINOIS, P.C. (NPI# 1245281583) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1245281583 |
Entity Type | Organization |
Organization Name | PSYCHOLOGICAL SERVICES OF CENTRAL ILLINOIS, P.C. |
Practice Address |
2921 Greenbriar Dr Suite B-1 Springfield IL 62704-6425 |
Practice Telephone | 2175463118 |
Practice Fax Number | 2175463184 |
Mailing Telephone | 2175463118 |
Mailing Fax Number | 2175463184 |
Enumeration Date | 2006-05-12 |
Last Update Date | 2008-04-20 |
Authorized Official Name | DR. RICHARD E. DIMOND (PRESIDENT) |
Authorized Official Telephone | 2175463118 |
Authorized Official Credential | PH.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | HMO ILLINOIS | 0008423762 | 01 |
IL | BLUE CROSS-BLUE SHIELD | 0008423762 | 01 |
Street Address |
2921 GREENBRIAR DR SUITE B-1 |
City | SPRINGFIELD |
State | IL |
Zip Code | 62704-6425 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225024136 | Patricia Reichart | Nurse Practitioner | 2921 Greenbriar Dr, Ste C, Springfield, IL 62704 | 2005-09-26 |
1194128389 | Cheryl Lee Affrunti | Psychologist | 2921 Greenbriar Dr, Ste. B-1, Springfield, IL 62704-6421 | 2014-10-01 |
1396084653 | Kristen Lyn Wade | Physical Therapist | 2921 Greenbriar Dr, Suite B, Springfield, IL 62704-6421 | 2013-02-06 |
1639447295 | Darrell B Simmermaker | Physical Therapy Assistant | 2921 Greenbriar Dr, Suite B, Springfield, IL 62704-6421 | 2011-12-09 |
1386923043 | Laurie Ann Salvacion | Physical Therapist | 2921 Greenbriar Dr, Suite B, Springfield, IL 62704-6421 | 2011-08-12 |
1235421603 | Craig A Backs Md LLC | Internal Medicine | 2921 Greenbriar Dr, Suite C, Springfield, IL 62704-6421 | 2011-05-04 |
1629200548 | Bradley M. Blevins | Physical Therapy Assistant | 2921 Greenbriar Dr, Suite B-2, Springfield, IL 62704-6421 | 2009-08-11 |
1801957055 | Physiotherapy Professionals LLC | Physical Therapist | 2921 Greenbriar Dr, Suite B-2, Springfield, IL 62704-6421 | 2006-12-12 |
1124043252 | Craig A Backs | Internal Medicine | 2921 Greenbriar Dr, Springfield, IL 62704-6421 | 2006-07-12 |
1548212145 | Richard E Dimond | Psychologist | 2921 Greenbriar Dr, Suite B-1, Springfield, IL 62704-6425 | 2006-05-16 |
Find all providers in the same location |
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 PSYCHOLOGICAL SERVICES OF CENTRAL ILLINOIS, P.C..
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.