Amy Fayazrad, PSY.D.
Individual provider Active NPI Mental Health Counselor · Arlington Heights, IL
NPI 1043440910 · NPPES record last updated Sep 30, 2015
Key facts
- NPI
- 1043440910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 825 E Golf Rd
Suite 1127
Arlington Heights, IL 60005-5700 - Phone
- (847) 981-9200
- NPI assigned
- Jul 24, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3633 W Lake Ave
Suite 306
Glenview, IL 60026-5803
Phone (760) 831-1191
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160127002297 | IL | Practitioner - Clinical Psychologist | 2668775479 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy Fayazrad & Associates, PC | Current |
Accepting new patients |
Locations
3633 W Lake Ave
Ste 306
Glenview, IL 60026
Phone (312) 285-4729
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
825 E Golf Rd
Suite 1127
Arlington Heights, IL 60005-5700
Mailing address
825 E Golf Rd
Suite 1127
Arlington Heights, IL 60005-5700
Phone (847) 981-9200
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.