Active NPI
Gabrielle Kaminsky, PHD
- Clinical Psychologist
- Springfield, IL
National Provider Identifier
1043981269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.010617
- Practice address
- 2501 Chatham Rd Ste 8022
Springfield, IL 62704-4188 - Phone
- (312) 447-9514
- NPI assigned
- Sep 27, 2021
- Last updated
- Dec 1, 2023
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.010617 | IL | Primary |
Addresses
Primary practice location
2501 Chatham Rd Ste 8022
Springfield, IL 62704-4188
Mailing address
2501 Chatham Rd Ste 8022
Springfield, IL 62704-4188
Phone (312) 447-9514
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071.010617 | IL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1043981269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2501 CHATHAM RD STE 8022",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627044188",
"telephone_number": "312-447-9514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 CHATHAM RD STE 8022",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627044188",
"telephone_number": "312-447-9514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMINSKY",
"first_name": "GABRIELLE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-27",
"last_updated": "2023-12-01",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.010617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.