Individual provider Active NPI

Kristi L Brower, PSY.D.

  • Clinical Psychologist
  • Sycamore, IL
National Provider Identifier
1447418488
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.007452 Issued in IL
Practice address
1625 Bethany Rd
Sycamore, IL 60178-3124
Phone
(779) 777-7335
Fax
(815) 758-8440
NPI assigned
May 27, 2008
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.007452 IL
Cognitive & Behavioral Psychologist 103TB0200X 071.007452
Health Psychologist 103TH0004X 071.007452
Clinical Psychologist 103TC0700X 071.007452 IL Primary

Addresses

Primary practice location

1625 Bethany Rd
Sycamore, IL 60178-3124

Mailing address

PO Box 276
Sycamore, IL 60178-0276
Phone (815) 758-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100722000467 IL Practitioner - Clinical Psychologist 2961534532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Services in Health Psychology, LTDGroup PAC ID 4981736550, 19 clinicians

Practice addresses (Care Compare)

1625 Bethany Rd
Sycamore, IL 60178-3124
Phone (779) 777-7335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071.007452ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Services in Health Psychology, LTD Cognitive & Behavioral CurrentSince May 1, 2010 Accepting new patients
Three Birds Mental Health Services PLLC PastSince May 1, 2010 Accepting new patients

Locations

1625 Bethany Rd
Sycamore, IL 60178
Phone (779) 777-7335

1625 Bethany Rd
Ste 1
Sycamore, IL 60178
Phone (779) 777-7335

1958 Aberdeen Ct
Ste 2
Sycamore, IL 60178
Phone (630) 618-9152

2540 Hauser Ross Dr
Ste 225
Sycamore, IL 60178
Phone (815) 758-8400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1447418488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601780276",
            "telephone_number": "815-758-8400",
            "fax_number": "815-758-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 BETHANY RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783124",
            "telephone_number": "779-777-7335",
            "fax_number": "815-758-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWER",
        "first_name": "KRISTI",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.007452",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": "071.007452",
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": null,
            "license": "071.007452",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

Verify at the official NPI Registry.