NPIMap

Organization Active NPI

Mental Health Partnership LTD

  • Clinical Psychologist
  • Sycamore, IL
National Provider Identifier
1205507407
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MENTAL HEALTH PARTNERSHIP LTD
Practice address
1625 Bethany Rd
Sycamore, IL 60178-3124
Phone
(815) 403-9463
NPI assigned
Sep 27, 2021
Last updated
Sep 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Dr. Erica Marie Veach, PSY.DNPI 1700321106
Title
Licensed Clinical Psychologist
Phone
(815) 403-9463

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1625 Bethany Rd
Sycamore, IL 60178-3124

Mailing address

1625 Bethany Rd
Sycamore, IL 60178-3124
Phone (815) 403-9463

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230106000059 IL Part B Supplier - Clinic/Group Practice 8527438605 Receives reassigned benefits from 7 practitioners
Practice locations: McHenry, IL

National Provider Directory

National Provider Directory

Locations

5435 Bull Valley Rd
Ste 206
McHenry, IL 60050
Phone (815) 575-8181

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1205507407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 BETHANY RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783124",
            "telephone_number": "815-403-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 BETHANY RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783124",
            "telephone_number": "815-403-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH PARTNERSHIP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "VEACH",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "815-403-9463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.