Organization Active NPI

Hoffmann Burchett Psychological Services, LLC

  • Clinical Psychologist
  • Bloomington, IL
National Provider Identifier
1477860609
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0071006988 Issued in IL
Legal business name
HOFFMANN BURCHETT PSYCHOLOGICAL SERVICES, LLC
Practice address
205 N Williamsburg Dr
Suite F
Bloomington, IL 61704-7706
Phone
(309) 830-8099
Fax
(309) 454-5153
NPI assigned
Sep 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Authorized official

Name
Dr. Christina M. Burchett, PH.D.NPI 1134238264
Title
Licensed Clinical Psychologist
Phone
(309) 830-8099

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 0071006988 IL Primary

Addresses

Primary practice location

205 N Williamsburg Dr
Suite F
Bloomington, IL 61704-7706

Mailing address

205 N Williamsburg Dr
Suite F
Bloomington, IL 61704-7706
Phone (309) 830-8099

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012001054 IL Part B Supplier - Clinic/Group Practice 7810189610 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomington, IL

National Provider Directory

National Provider Directory

Locations

205 N Williamsburg Dr
Bloomington, IL 61704
Phone (309) 222-8315

205 N Williamsburg Dr
Ste F
Bloomington, IL 61704
Phone (309) 830-8099

211 Landmark Dr
Ste B4
Normal, IL 61761
Phone (309) 830-8099

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297036800000",
    "number": "1477860609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 N WILLIAMSBURG DR",
            "address_2": "SUITE F",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047706",
            "telephone_number": "309-830-8099",
            "fax_number": "309-454-5153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N WILLIAMSBURG DR",
            "address_2": "SUITE F",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047706",
            "telephone_number": "309-830-8099",
            "fax_number": "309-454-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOFFMANN BURCHETT PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2011-02-07",
        "status": "A",
        "authorized_official_last_name": "BURCHETT",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "LICENSED CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "309-830-8099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "0071006988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.