Individual provider Active NPI

Sarah May Van Nostrand, PSY.D

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1215410899
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.011042 Issued in IL
Practice address
708 Church St Ste 251
Evanston, IL 60201-3840
Phone
(847) 462-4849
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071.011042 IL Primary

Addresses

Primary practice location

708 Church St Ste 251
Evanston, IL 60201-3840

Mailing address

708 Church St Ste 251
Evanston, IL 60201-3840
Phone (847) 462-4849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 5, 2025 through Mar 5, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.011042ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Awakening, PC Clinical PastSince Nov 1, 2023 Accepting new patients
Moonrise Therapy PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1215410899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST STE 251",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013840",
            "telephone_number": "847-462-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 CHURCH ST STE 251",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013840",
            "telephone_number": "847-462-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN NOSTRAND",
        "first_name": "SARAH",
        "middle_name": "MAY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.