David Barecki, PSY.D.
Individual provider Active NPI Clinical Psychologist · Oak Forest, IL
NPI 1124388574 · NPPES record last updated Oct 6, 2021
Key facts
- NPI
- 1124388574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 071010561 (IL)
- Practice address
- 6006 159TH St BLDG C
Oak Forest, IL 60452-2904 - Phone
- (708) 535-7320
- NPI assigned
- May 19, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250715002846 | IL | Practitioner - Clinical Psychologist | 5092220335 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Genesis Therapy Center | Current | Accepting new patients | |
| Genesis Therapy Center | Mental Health | Current |
Accepting new patients |
Locations
6006 159th St
Bldg C
Oak Forest, IL 60452
Phone (708) 535-7320
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071010561 | IL | Yes |
Addresses
Primary practice location
6006 159TH St BLDG C
Oak Forest, IL 60452-2904
Mailing address
106 N Vincent Dr
Bolingbrook, IL 60490-5586
Phone (773) 459-2856
Other providers in Oak Forest, IL
- Allison Baker
- Paige Baker
- Benjamin Balaskas
- Lorraine Bangayan
- Krystle Banzuela
- Fahmeeda Begum
- Debra L Bennett Carey
- Ronald L Berger
- Deborah Bernabei
- Elanie Gail Berthel
All providers in Oak Forest, IL · Clinical Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.