Individual provider Active NPI

Connie Valentini, PSY.D.

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1104885334
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006131 Issued in IL
Practice address
7 Blanchard Cir Ste 201
Wheaton, IL 60189-2039
Phone
(630) 653-2300
NPI assigned
Mar 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071006131 IL Primary

Addresses

Primary practice location

7 Blanchard Cir Ste 201
Wheaton, IL 60189-2039

Mailing address

7 Blanchard Cir
Suite 201
Wheaton, IL 60189-2039
Phone (630) 653-2300

Other identifiers 1

IdentifierTypeStateIssuer
02215643OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Concordia Valentini Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120118000283 IL Practitioner - Clinical Psychologist 3870760796 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

400 W Roosevelt Rd
Suite 230
Wheaton, IL 60187-2329
Phone (630) 632-5158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Valentini Therapy LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

400 W Roosevelt Rd
Ste 230
Wheaton, IL 60187
Phone (630) 632-5158

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1104885334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR",
            "address_2": "SUITE 201",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892039",
            "telephone_number": "630-653-2300",
            "fax_number": "630-653-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 BLANCHARD CIR STE 201",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601892039",
            "telephone_number": "630-653-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINI",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-17",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02215643",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONCORDIA",
            "last_name": "VALENTINI",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.