Introspective Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

INTROSPECTIVE PSYCHOLOGICAL SERVICES, LLC

Practice address

1502 W Chicago Ave # 1
Chicago, IL 60642-5236

Phone

(312) 625-9051

NPI assigned

Sep 28, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Rielle Johnson, PSY.D.NPI 1831591197

Title

Owner

Phone

(312) 625-9051

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rielle Johnson, PSYD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1831591197
  NPD Authorized official
• Chelsey Lea Jones

  • Mental Health Counselor
  • Los Angeles, CA
  • NPI 1124571245
  NPD

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

{
    "created_epoch": "1601251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1164039822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 W WARREN BLVD APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W CHICAGO AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606425236",
            "telephone_number": "312-625-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTROSPECTIVE PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-28",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-625-9051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.