Individual provider Active NPI

Linda J. Wright, PSY.D.

  • Clinical Psychologist
  • Homewood, IL
National Provider Identifier
1285631291
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-003283 Issued in IL
Practice address
18161 Morris Ave
Suite 104
Homewood, IL 60430-2108
Phone
(708) 798-6032
Fax
(708) 535-0532
NPI assigned
Jul 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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 071-003283 IL Primary

Addresses

Primary practice location

18161 Morris Ave
Suite 104
Homewood, IL 60430-2108

Mailing address

18161 Morris Ave
Suite 104
Homewood, IL 60430-2140
Phone (708) 798-6032

Other identifiers 6

IdentifierTypeStateIssuer
004542679OtherILAETNA
054798000OtherILMAGELLAN BEHAVIORAL HEALT
090044OtherILMANAGED HEALTH NETWORK
0001673252OtherILBLUE CROSS BLUE SHIELD
280937OtherILVALUE OPTIONS
071-003283OtherILCLIN PSYCHOLOGY LICENSE

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
I20041108001160 IL Practitioner - Clinical Psychologist 3375506603 Practice locations: Frankfort, IL; Homewood, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18161 Morris Ave
Suite 104
Homewood, IL 60430-2140
Phone (708) 798-6032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071-003283ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1285631291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18161 MORRIS AVE",
            "address_2": "SUITE 104",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302140",
            "telephone_number": "708-798-6032",
            "fax_number": "708-535-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18161 MORRIS AVE",
            "address_2": "SUITE 104",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302108",
            "telephone_number": "708-798-6032",
            "fax_number": "708-535-0532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "LINDA J.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-003283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "004542679",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "054798000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "090044",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001673252",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "280937",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIN PSYCHOLOGY LICENSE",
            "identifier": "071-003283",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

Verify at the official NPI Registry.