Riverside Psychology

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Legal business name

RIVERSIDE PSYCHOLOGY

Practice address

7627 Lake St Ste 222
River Forest, IL 60305-1806

Phone

(708) 762-9602

NPI assigned

Aug 15, 2022

Organization subpart

No

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

Authorized official

Name

Megan Baldassarre, PSYDNPI 1710332754

Title

Owner

Phone

(708) 762-9602

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Megan A Baldassarre, PSYD

  • Clinical Neuropsychologist
  • Lake Barrington, IL
  • NPI 1710332754
  Medicare reassignment NPD Authorized official
• Sophia Parmacek, LPC

  • Professional Counselor
  • River Forest, IL
  • NPI 1487446589
  NPD

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

{
    "created_epoch": "1660521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666310400000",
    "number": "1083342299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7627 LAKE ST STE 222",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051806",
            "telephone_number": "708-762-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7627 LAKE ST STE 222",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051806",
            "telephone_number": "708-762-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A",
        "authorized_official_last_name": "BALDASSARRE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-762-9602",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River Forest Medical Associates
• River Forest Public School District 90
• River Forest Surgery Center LLC
• River Forest Surgery Center LLC
• River Grove Medical Partners, LTD
• Monika Inge Robinson, OTR/L
• Romano Orthopaedics LLC
• Victor M. Romano, M.D.
• Rachel Rosa, PA-C
• Ross a. Fraser, DDS PC

• Clinical Neuropsychologist in River Forest, IL
• Providers in River Forest, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.