Active NPI
Brian Stephen Daniels, PSYD, MS
- Psychologist
- Chicago, IL
National Provider Identifier
1336826817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY.0006115
- Practice address
- 2020 N California Ave Ste 7
Unit 295
Chicago, IL 60647 - Phone
- (216) 346-5467
- NPI assigned
- Jun 28, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY.0006115 | CO | Primary |
Addresses
Primary practice location
2020 N California Ave Ste 7
Unit 295
Chicago, IL 60647
Mailing address
2020 N California Ave Ste 7
Unit 295
Chicago, IL 60647
Phone (216) 346-5467
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY.0006115 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687910400000",
"number": "1336826817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 N CALIFORNIA AVE STE 7",
"address_2": "UNIT 295",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60647",
"telephone_number": "216-346-5467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 N CALIFORNIA AVE STE 7",
"address_2": "UNIT 295",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60647",
"telephone_number": "216-346-5467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELS",
"first_name": "BRIAN",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "PSYD, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "PSY.0006115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.