Active NPI
Shadequia Davis, MS, NCSP
- School Psychologist
- Joliet, IL
National Provider Identifier
1033724232
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 2489765
- Practice address
- 402 Richards St
Joliet, IL 60433-2218 - Phone
- (815) 727-5271
- NPI assigned
- Sep 14, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 2489765 | IL | Primary |
Addresses
Primary practice location
402 Richards St
Joliet, IL 60433-2218
Mailing address
1440 S Michigan Ave Apt 312
Chicago, IL 60605-2956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2489765 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1033724232",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 S MICHIGAN AVE APT 312",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606052956"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 RICHARDS ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604332218",
"telephone_number": "815-727-5271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SHADEQUIA",
"credential": "MS, NCSP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "2489765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.