Individual provider Active NPI

Elizabeth Catherine Tingley, PH.D.

  • Clinical Psychologist
  • Champaign, IL
National Provider Identifier
1265630537
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009597 Issued in IL
Practice address
Department of Psychiatry and Psychology-Carle Physician
1802 S. Mattis
Champaign, IL 61821
Phone
(217) 365-2856
Fax
(217) 365-2856
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071009597 IL Primary
Clinical Psychologist 103TC0700X 016572-1 NY
Psychologist 103T00000X 071009597 IL

Addresses

Primary practice location

Department of Psychiatry and Psychology-Carle Physician
1802 S. Mattis
Champaign, IL 61821

Mailing address

1802 S Mattis Ave
Champaign, IL 61821-5923
Phone (217) 365-2856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024003235 IL Practitioner - Clinical Psychologist 3779859442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

1802 S Mattis Ave
Champaign, IL 61821-5923
Phone (217) 326-1330

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071009597ILMDClinical Psychologist
016572-1NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Feb 23, 2019 Accepting new patients

Locations

1802 S Mattis Ave
Champaign, IL 61821
Phone (217) 365-2855

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 1

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1265630537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 S MATTIS AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215923",
            "telephone_number": "217-365-2856",
            "fax_number": "217-365-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PSYCHIATRY AND PSYCHOLOGY-CARLE PHYSICIAN",
            "address_2": "1802 S. MATTIS",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61821",
            "telephone_number": "217-365-2856",
            "fax_number": "217-365-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINGLEY",
        "first_name": "ELIZABETH",
        "middle_name": "CATHERINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009597",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016572-1",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071009597",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.