Michael Edwin Bricker, PH.D., LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.007755 Issued in IL

Practice address

655 W Irving Park Rd
Suite 201
Chicago, IL 60613-3123

Phone

(773) 527-1304

NPI assigned

Aug 6, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 28, 2016 through Jun 28, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Psychological Services, PC

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1033570296
  NPD (past) Authorized official

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1336305671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W IRVING PARK RD",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133123",
            "telephone_number": "773-428-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W IRVING PARK RD",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133123",
            "telephone_number": "773-527-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRICKER",
        "first_name": "MICHAEL",
        "middle_name": "EDWIN",
        "name_prefix": "Dr.",
        "credential": "PH.D., LCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-06",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Marie Brice, MS, CCC-SLP
• Elizabeth A Brice, LCSW
• Michele Brice
• Jori Brick
• Jonathan Tyler Bricker
• Sarah Bricker, LCSW
• Corrie Brickey, LCSW
• Aura Brickler, MSW, LCSW
• Celia E. Brickman, PH.D., L.C.P.C.
• Clifford Brickman, DN, DCSW, LCSW

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.