Samantha Jean Tippy, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010775 Issued in IL

Practice address

210 N Hammes Ave Ste 205
Joliet, IL 60435-8139

Phone

(815) 210-5045

Fax

(815) 725-8144

NPI assigned

Jun 12, 2022

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Joliet Center for Clinical Research, Inc

  • Psychiatry Physician
  • Joliet, IL
  • NPI 1760647226

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1093445249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE STE 205",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358139",
            "telephone_number": "815-729-7790",
            "fax_number": "815-725-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HAMMES AVE STE 205",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604358139",
            "telephone_number": "815-210-5045",
            "fax_number": "815-725-8144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPY",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Thompson, FNP-C
• Robert Thorsness, M.D.
• Breck Michael Tiernan, DPM
• Sharon Marie Tierney, PTA
• Veveca A Tikasingh, L.C.S.W
• Ann E Todd, O.D.
• Olga Toerber
• Ann Tolene, APN
• Peter P Tomas, M.D.
• Francis G Tomasik, MD

• Clinical Psychologist in Joliet, IL
• Providers in Joliet, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.