Katelyn Houba, SSP

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

1308053 Issued in IL

Practice address

1525 Locust St
Red Bud, IL 62278-1374

Phone

(618) 282-6251

NPI assigned

Aug 13, 2024

Last updated

Aug 13, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Perandoe Special Education District

  • Local Education Agency (LEA)
  • Red Bud, IL
  • NPI 1871792648
  NPD (past)

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

{
    "created_epoch": "1723507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1043041692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 LOCUST ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781374",
            "telephone_number": "618-282-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LOCUST ST",
            "city": "RED BUD",
            "state": "IL",
            "postal_code": "622781374",
            "telephone_number": "618-282-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUBA",
        "first_name": "KATELYN",
        "credential": "SSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-13",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "1308053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Red Bud, IL
• Providers in Red Bud, IL by specialty
• School Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.