NPIMap

Organization Active NPI

Graceway Psychology Group, LLC

  • Clinical Psychologist
  • Champaign, IL
National Provider Identifier
1275900896
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GRACEWAY PSYCHOLOGY GROUP, LLC
Practice address
201 W Springfield Ave Ste 211
Champaign, IL 61820-4880
Phone
(217) 621-6180
NPI assigned
Aug 31, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
Weimin Grace Blocher, PHDNPI 1235577990
Title
Owner
Phone
(217) 621-6180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

201 W Springfield Ave Ste 211
Champaign, IL 61820-4880

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 926-8320

National Provider Directory

National Provider Directory

Locations

201 W Springfield Ave
Ste 211
Champaign, IL 61820
Phone (217) 621-6180

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1275900896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-926-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W SPRINGFIELD AVE STE 211",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204880",
            "telephone_number": "217-621-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACEWAY PSYCHOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "BLOCHER",
        "authorized_official_first_name": "WEIMIN",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-621-6180",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.