Ink & Ivy Psychiatry, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

INK & IVY PSYCHIATRY, LLC

Practice address

203 S Main St
Dieterich, IL 62424-1128

Phone

(618) 852-1395

NPI assigned

May 21, 2026

Organization subpart

No

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

Authorized official

Name

Jacklyn Stanley, APRNNPI 1073285482

Title

Pmhnp

Phone

(618) 852-1395

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacklyn Kay Stanley, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Clay City, IL
  • NPI 1073285482

  Psychiatric/Mental Health

  NPD Authorized official

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

{
    "created_epoch": "1779321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1023948973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E WALNUT ST",
            "city": "NOBLE",
            "state": "IL",
            "postal_code": "628681709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S MAIN ST",
            "city": "DIETERICH",
            "state": "IL",
            "postal_code": "624241128",
            "telephone_number": "618-852-1395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INK & IVY PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "JACKLYN",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "618-852-1395",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Rae Braddy, M.D.
• Keli J. Dhom, PT
• Dieterich Comm Unit 30
• HSHS Medical Group Inc
• Jennifer Tinsley Pmhnp-BC, PLLC
• Kristen Rose Kennedy, M.S. CCC-SLP
• Jennifer Elizabeth Kistner, FNP
• Debra Kitten
• Angela Koester, COTA/L

• All providers in Dieterich, IL
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.