Individual provider Active NPI

Kristin Clifford, PSY.D.

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1265804330
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009242 Issued in IL
Practice address
200 E 5TH Ave
Naperville, IL 60563-3100
Phone
(331) 444-2757
NPI assigned
Oct 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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 071009242 IL Primary

Addresses

Primary practice location

200 E 5TH Ave
Naperville, IL 60563-3100

Mailing address

68 Rock River CT
Naperville, IL 60565-6347
Phone (630) 386-1909

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
I20160203000838 IL Practitioner - Clinical Psychologist 7719281294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alw Group GrowGroup PAC ID 3971910530, 17 clinicians

Practice addresses (Care Compare)

200 E 5TH Ave
Suite 109
Naperville, IL 60563-3173
Phone (331) 457-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071009242ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Alw Group Grow CurrentSince Jun 1, 2021 Accepting new patients

Locations

200 E 5th Ave
Ste 109
Naperville, IL 60563
Phone (331) 248-6194

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": "1445990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1265804330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 ROCK RIVER CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605656347",
            "telephone_number": "630-386-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 5TH AVE",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605633100",
            "telephone_number": "331-444-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-28",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.