Prairie Psychotherapy Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071005595 Issued in IL

Legal business name

PRAIRIE PSYCHOTHERAPY SERVICES LLC

Practice address

335 N River St
Suite 210
Batavia, IL 60510-2386

Phone

(630) 879-8164

NPI assigned

Jul 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Amy H. Macdonald, PSY.D.NPI 1881750495

Title

Owner

Phone

(630) 879-8164

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 6

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

• Amy H. Macdonald, PSY.D.

  • Clinical Psychologist
  • Batavia, IL
  • NPI 1881750495
  Medicare reassignment NPD Authorized official
• Diane F Mittelhauser, PSYD

  • Clinical Psychologist
  • Batavia, IL
  • NPI 1497815617
  Medicare reassignment NPD
• Dianne L Grande, PH.D.

  • Clinical Psychologist
  • Batavia, IL
  • NPI 1669581724
  NPD (past)
• Kurt Heist, PSY.D.

  • Clinical Psychologist
  • Aurora, IL
  • NPI 1316345317
  NPD (past)
• Riley Klink, PSYD

  • Clinical Psychologist
  • Batavia, IL
  • NPI 1417747817
  NPD (past)
• Brian W. Rooney, PH.D.

  • Clinical Psychologist
  • Batavia, IL
  • NPI 1801954896
  NPD (past)

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

{
    "created_epoch": "1278547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1497067292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N RIVER ST #210",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "60510",
            "telephone_number": "630-879-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N RIVER ST",
            "address_2": "SUITE 210",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605102386",
            "telephone_number": "630-879-8164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE PSYCHOTHERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-08",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-879-8164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ILLINOIS",
            "identifier": "4523298",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaley Ann Phelan, DPT
• Brianna Phillips
• Bailey Catherine Pihera, RDN, CPT
• Michele Polarek
• Aimie N. Pollard, M.A., SLP
• Prairie Wellness Counseling Center, P.C.
• Carol L Pranger, L.C.P.C.
• Debra Prebys, OTR/L
• Precision Audiology and Hearing Services, Inc.
• Norma Price, COTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.