Priebe Psychological & Wellness

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PRIEBE PSYCHOLOGICAL & WELLNESS

Practice address

101 N Marion St Ste 201
Oak Park, IL 60301-1023

Phone

(708) 232-0925

NPI assigned

Oct 14, 2019

Organization subpart

No

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

Authorized official

Name

Suzanne Priebe, PSYDNPI 1346374261

Title

Owner

Phone

(708) 232-0925

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

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

• Suzanne Jeanette Priebe, PH.D

  • Clinical Psychologist
  • Evergreen, CO
  • NPI 1346374261

  CO

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576195200000",
    "number": "1497397228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7968 IOWA ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051346",
            "telephone_number": "847-406-6359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MARION ST STE 201",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011023",
            "telephone_number": "708-232-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIEBE PSYCHOLOGICAL & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A",
        "authorized_official_last_name": "PRIEBE",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-232-0925",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.