NPIMap

Organization Active NPI

Harvard Psychology and Associates

  • Clinical Psychologist
  • Harvard, IL
National Provider Identifier
1205376043
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006392 Issued in IL
Legal business name
HARVARD PSYCHOLOGY AND ASSOCIATES
Practice address
107 E Sumner St
Suite 1
Harvard, IL 60033-2840
Phone
(815) 814-4193
Fax
(815) 943-6540
NPI assigned
Feb 27, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Authorized official

Name
Dr. Elizabeth Sukowicz, PH.D.NPI 1134215130
Title
Owner
Phone
(815) 814-4193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071006392 IL Primary

Addresses

Primary practice location

107 E Sumner St
Suite 1
Harvard, IL 60033-2840

Mailing address

107 E Sumner St
Suite 1
Harvard, IL 60033-2840
Phone (815) 814-4193

Other identifiers 2

IdentifierTypeStateIssuer
1134215130OtherILINDIVIDUAL NPI
345468451001MedicaidIL

National Provider Directory

National Provider Directory

Locations

107 E Sumner St
Ste 1
Harvard, IL 60033
Phone (815) 814-4193

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1205376043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 E SUMNER ST",
            "address_2": "SUITE 1",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600332840",
            "telephone_number": "815-814-4193",
            "fax_number": "815-943-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 E SUMNER ST",
            "address_2": "SUITE 1",
            "city": "HARVARD",
            "state": "IL",
            "postal_code": "600332840",
            "telephone_number": "815-814-4193",
            "fax_number": "815-943-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD PSYCHOLOGY AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "SUKOWICZ",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-814-4193",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1134215130",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345468451001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.