Jenna Yates

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009981 Issued in IL

Practice address

3233 Mathers Rd Ste a
Springfield, IL 62711-7900

Phone

(217) 899-5412

NPI assigned

Mar 25, 2018

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenna.yates.1@26421.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/26421/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jenna Reid Yates, PH.D., Licensed Clinical Psychologist, LLC

  • Clinical Psychologist
  • Springfield, IL
  • NPI 1831820547
  NPD Authorized official
• Springfield Psychological Center, LLC

  • Clinical Psychologist
  • Springfield, IL
  • NPI 1174749881
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1013412931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3233 MATHERS RD STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117900",
            "telephone_number": "217-414-2064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3233 MATHERS RD STE A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117900",
            "telephone_number": "217-899-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YATES",
        "first_name": "JENNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-25",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011471",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Cody Yarnell, MD
• Susan Gail Yarrington, LCPC
• Maryam Yaseen
• Basma Yasir Nouri Ahmed, MD
• Christine Alysse Yates, PHARMD
• Seth Bryan Yates, DO
• Amy Yeates, DNP
• Sevan Yeghiazarian, M.D.
• Sandra Yeh, MD
• Cynthia K Yergler, RD LD CDE

• Clinical Psychologist in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.