Active NPI
Kimberly S Nelson-Arrington, PSYD, PHD
- Clinical Psychologist
- Glenwood, IL
National Provider Identifier
1114214020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071011441
- Practice address
- 700 N Bruce LN Apt 307
Glenwood, IL 60425-1134 - Phone
- (708) 740-5263
- Fax
- (708) 248-6416
- NPI assigned
- Jun 30, 2011
- Last updated
- May 7, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 | 071011441 | IL | Primary |
Addresses
Primary practice location
700 N Bruce LN Apt 307
Glenwood, IL 60425-1134
Mailing address
18300 S Halsted St Ste B
Glenwood, IL 60425-1051
Phone (312) 259-3166
Other practice location 1
13811 Western Ave Bldg D
Blue Island, IL 60406-3228
Phone (708) 252-3185
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071011441 | IL | MD | Clinical Psychologist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Glenwood, IL
- NPI 1447996590
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746576000000",
"number": "1114214020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18300 S HALSTED ST STE B",
"city": "GLENWOOD",
"state": "IL",
"postal_code": "604251051",
"telephone_number": "312-259-3166",
"fax_number": "708-248-6416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 N BRUCE LN APT 307",
"city": "GLENWOOD",
"state": "IL",
"postal_code": "604251134",
"telephone_number": "708-740-5263",
"fax_number": "708-248-6416"
}
],
"practiceLocations": [
{
"address_1": "13811 Western Ave Bldg D",
"address_purpose": "LOCATION",
"city": "Blue Island",
"state": "IL",
"postal_code": "604063228",
"country_code": "US",
"telephone_number": "708-252-3185",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NELSON-ARRINGTON",
"first_name": "KIMBERLY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PSYD, PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-30",
"last_updated": "2025-05-07",
"certification_date": "2025-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071011441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenwood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; 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.