Individual provider Active NPI

Ericka Joy Swanson, PSY.D.

  • Psychologist
  • Frankfort, IL
National Provider Identifier
1285944900
Registry record updated Oct 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.007992 Issued in IL
Practice address
20550 Lagrange Rd
Suite 105
Frankfort, IL 60423
Phone
(708) 448-3300
NPI assigned
Oct 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.007992 IL Primary
Psychologist 103T00000X 20042445A IN

Addresses

Primary practice location

20550 Lagrange Rd
Suite 105
Frankfort, IL 60423

Mailing address

13011 S. 104TH Avenue
Suite 200
Palos Park, IL 60464
Phone (708) 448-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110304000825 IL Practitioner - Clinical Psychologist 7113109679
I20210304002234 IN Practitioner - Clinical Psychologist 7113109679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9305 Calumet Ave
Suite C2
Munster, IN 46321-2888
Phone (219) 805-0451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.007992ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ericka Swanson PSYD Inc. Psychologist CurrentSince Dec 2, 2020 Accepting new patients
Marlin C Hoover PHD PC CurrentSince Oct 26, 2010 Accepting new patients
Miracare Neuro Behavioral Health, PC Psychologist Past Accepting new patients

Locations

16325 Harlem Ave
Tinley Park, IL 60477
Phone (708) 403-9556

9305 Calumet Ave
Ste C2
Munster, IN 46321
Phone (219) 805-0451

Organizations & group practices 3

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": "1287100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287100800000",
    "number": "1285944900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 S. 104TH AVENUE",
            "address_2": "SUITE 200",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "60464",
            "telephone_number": "708-448-3300",
            "fax_number": "708-448-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20550 LAGRANGE RD",
            "address_2": "SUITE 105",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "60423",
            "telephone_number": "708-448-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "ERICKA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.007992",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042445A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

Verify at the official NPI Registry.