Edumedia Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.003813 Issued in IL

Legal business name

EDUMEDIA INC.

Practice address

129 Welwyn St
Lake Bluff, IL 60044-1151

Phone

(847) 604-4040

NPI assigned

Nov 29, 2011

Last updated

Dec 14, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Martin MC Carthy, Jr. Jr., PH.D.

Title

Clinical Psychologist

Phone

(847) 475-1988

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Martin McCarthy Jr., PH.D.

  • Psychologist
  • Evanston, IL
  • NPI 1588891592
  Medicare reassignment NPD

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

{
    "created_epoch": "1322524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1457628836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 WELWYN ST",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441151",
            "telephone_number": "847-604-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 WELWYN ST",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600441151",
            "telephone_number": "847-604-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUMEDIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-29",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "MC CARTHY, JR.",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "847-475-1988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.003813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Lake Bluff, IL
• Providers in Lake Bluff, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; 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.