Neurorehab Psychology Consultants, LLC

Primary specialty

Rehabilitation PsychologistTaxonomy code 103TR0400X

License

071.009251 Issued in IL

Legal business name

NEUROREHAB PSYCHOLOGY CONSULTANTS, LLC

Practice address

419 Center St Ste C
Grayslake, IL 60030-1645

Phone

(262) 412-7302

NPI assigned

Nov 5, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Danielle M Ciccone-Coutre, PSYDNPI 1184085573

Title

Clinical Psychologist/President

Phone

(262) 412-7302

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Danielle Marie Ciccone- Coutre, PSY.D.

  • Clinical Psychologist
  • Grayslake, IL
  • NPI 1184085573
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1509840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524700800000",
    "number": "1245742865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11314 E RIVIERA DR",
            "city": "SPRING GROVE",
            "state": "IL",
            "postal_code": "600818146",
            "telephone_number": "262-412-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 CENTER ST STE C",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600301645",
            "telephone_number": "262-412-7302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROREHAB PSYCHOLOGY CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-05",
        "last_updated": "2018-04-26",
        "status": "A",
        "authorized_official_last_name": "CICCONE-COUTRE",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/PRESIDENT",
        "authorized_official_telephone_number": "262-412-7302",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": "IL",
            "license": "071.009251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Psychologist in Grayslake, IL
• Providers in Grayslake, IL by specialty
• Rehabilitation Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; 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.