Nicolas Brandon Warner, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071008256 Issued in IL

Practice address

4610 N Clark St # 1307
Chicago, IL 60640-4620

Phone

(773) 240-5151

Fax

(341) 689-3474

NPI assigned

Nov 30, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1255608683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 N CLARK ST # 1307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404620",
            "telephone_number": "773-240-5151",
            "fax_number": "341-689-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 N CLARK ST # 1307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404620",
            "telephone_number": "773-240-5151",
            "fax_number": "341-689-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "NICOLAS",
        "middle_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-30",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Dean Warner, OD
• Kathleen J Warner, DPT
• Kenya Monica Warner, CADC29177
• Kristina Janea Warner, MD
• Nathan Duane Warner, PA
• Sarah Warner, LSW
• Sarah Lynn Warner, M.A.ED., CCC-SLP
• Madison Warnick
• Pamela Warnick, M.D.
• Amanda Lauren Warnock, MPH, C-FSD(BADT)

• 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 Aug 2, 2024; 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.