Individual provider Active NPI

Madeleine Schwartz, PSYD

  • Clinical Psychologist
  • Deerfield, IL
National Provider Identifier
1316498157
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.011230 Issued in IL
Practice address
1717 Deerfield Rd Ste 110
Deerfield, IL 60015-3900
Phone
(847) 607-1416
NPI assigned
Oct 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Student in an Organized Health Care Education/Training Program 390200000X OH
Clinical Psychologist 103TC0700X 071.011230 IL Primary

Addresses

Primary practice location

1717 Deerfield Rd Ste 110
Deerfield, IL 60015-3900

Mailing address

1717 Deerfield Rd Ste 110
Deerfield, IL 60015-3900
Phone (847) 607-1416

Other practice location 1

11 Wilbraham Rd
Springfield, MA 01109-3161
Phone (413) 750-8662

Other practice location 2

6435 E Broad St
Columbus, OH 43213-1507
Phone (614) 355-8160

Other identifiers 1

IdentifierTypeStateIssuer
2846675MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071.011230ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Child and Family Services Past Accepting new patients

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1316498157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 DEERFIELD RD STE 110",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153900",
            "telephone_number": "847-607-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 DEERFIELD RD STE 110",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153900",
            "telephone_number": "847-607-1416"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Wilbraham Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011093161",
            "country_code": "US",
            "telephone_number": "413-750-8662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6435 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432131507",
            "country_code": "US",
            "telephone_number": "614-355-8160",
            "fax_number": "614-355-8180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "MADELEINE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.011230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.