Creating Peace of Mind Cognitive Behavioral Health-LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CREATING PEACE OF MIND COGNITIVE BEHAVIORAL HEALTH-LLC

Practice address

4010 N Illinois St Ste D
Swansea, IL 62226-1967

Phone

(618) 520-1764

Fax

(618) 825-9400

NPI assigned

Dec 17, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Robin L Dalske, PSYDNPI 1326361502

Title

Clinical Psychologist

Phone

(618) 408-1256

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Creating Peace of Mind, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robin L Dalske, PSYD

  • Clinical Psychologist
  • Swansea, IL
  • NPI 1326361502
  Medicare reassignment NPD Authorized official
• Morgan Ashley McDaniel, LPC

  • Professional Counselor
  • Swansea, IL
  • NPI 1811754302
  NPD
• Tara Elizabeth Casady, PHD

  • Clinical Psychologist
  • Saint Louis, MO
  • NPI 1568808194
  NPD (past)

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1427520352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 HILLSBORO AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251865",
            "telephone_number": "618-520-1764",
            "fax_number": "618-258-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 N ILLINOIS ST STE D",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622261967",
            "telephone_number": "618-520-1764",
            "fax_number": "618-825-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATING PEACE OF MIND COGNITIVE BEHAVIORAL HEALTH-LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-17",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "DALSKE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "618-408-1256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326361502",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Creating Peace of Mind, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.