Organization Active NPI

Center for Assessment and Psychological Services

  • Clinical Psychologist
  • Wheaton, IL
National Provider Identifier
1275692196
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071006135 Issued in IL
Legal business name
CENTER FOR ASSESSMENT AND PSYCHOLOGICAL SERVICES
Practice address
400 W Liberty
Suite C
Wheaton, IL 60187
Phone
(630) 260-1570
Fax
(630) 260-1576
NPI assigned
Dec 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Julia M Klco, PSY D
Title
Clinical Psychologist
Phone
(630) 546-6803

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071006135 IL Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 71007031 IL
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149010619 IL

Addresses

Primary practice location

400 W Liberty
Suite C
Wheaton, IL 60187

Mailing address

400 W Liberty
Suite C
Wheaton, IL 60187
Phone (630) 260-1570

Other identifiers 1

IdentifierTypeStateIssuer
2232532OtherBC

National Provider Directory

National Provider Directory

Locations

400 W Liberty Dr
Ste C
Wheaton, IL 60187
Phone (630) 260-1570

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1275692196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W LIBERTY",
            "address_2": "SUITE C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60187",
            "telephone_number": "630-260-1570",
            "fax_number": "630-260-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W LIBERTY",
            "address_2": "SUITE C",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60187",
            "telephone_number": "630-260-1570",
            "fax_number": "630-260-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ASSESSMENT AND PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "KLCO",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "630-546-6803",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071006135",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "71007031",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "2232532",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.