Krystel Segovia

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010908 Issued in IL

Practice address

5 Picnic CT
Bolingbrook, IL 60490-6542

Phone

(331) 213-1075

NPI assigned

Dec 29, 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

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.

• Evergreen Reflections PLLC

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1740099605
  Medicare reassignment NPD Authorized official
• Rising Phoenix Mental Health PLLC

  dba Ellie Mental Health

  • Clinical Psychologist
  • Burr Ridge, IL
  • NPI 1669180493
  Medicare reassignment NPD
• Samaritan Interfaith Counseling Center Inc.

  • Clinical Psychologist
  • Naperville, IL
  • NPI 1497842983
  Medicare reassignment NPD
• Chicagoland Counseling PLLC

  dba Ellie Mental Health

  • Clinical Social Worker
  • Aurora, IL
  • NPI 1265215925
  NPD (past)
• Samaritan Counseling Center

  • Marriage & Family Therapist
  • Winnetka, IL
  • NPI 1841397353
  NPD (past)

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734739200000",
    "number": "1154034650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PICNIC CT",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604906542",
            "telephone_number": "331-213-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 PICNIC CT",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604906542",
            "telephone_number": "331-213-1075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1819 Bay Scott Cir",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605401129",
            "country_code": "US",
            "telephone_number": "630-357-2456 x121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGOVIA",
        "first_name": "KRYSTEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Lynn Schmitt
• Itiona M Scott
• Jaime Lynn Scranton, LCSW
• Seek Healthcare Incorporated
• Rani Seeth, DDS
• Prakash Selvaraj, M.D.
• Rajakumari Prakash Selvaraj, M.D.
• Senior Estates Supportive Living Facility Limited Partnership (Heritage Woods of Bolingbrook)
• Marielle B Serenda, OD
• Serenity Signature Health LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; 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.