Kelsey Atteberry

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

1200 Locust St
Eldorado, IL 62930-1723

Phone

(618) 252-9036

NPI assigned

Aug 5, 2019

Sex

Female

Sole proprietor

No

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.

• Stress & Trauma Treatment Center, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Eldorado, IL
  • NPI 1851966014
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1366097669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 S TEXAS ST APT A",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629463020",
            "telephone_number": "317-430-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LOCUST ST",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629301723",
            "telephone_number": "618-252-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTEBERRY",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samir Fares Abdo, M.D.
• Albert G Bledig MD Chartered
• Philip Alkazoff
• Mindy Alvey
• Kathryn Bangs, PHD
• Loni J Banks, FNP
• Sierra Barker
• Alexandra Jean Barton, LPN
• Anita Gail Barton, RN

• All providers in Eldorado, IL
• School Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.