Kara Sue Cicciarelli, PHD, NCSP, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071011250 Issued in IL

Practice address

7317 N Willow Lake CT
Peoria, IL 61614-8227

Phone

(309) 683-7373

NPI assigned

Aug 6, 2024

Last updated

Aug 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  dba Physical Medicine & Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312

  Multi-Specialty

  Medicare reassignment NPD
• Saint Francis Medical Center

  dba Saint Francis Home Health

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  dba Multiple Hospital Departments

  • Nurse Practitioner
  • Peoria, IL
  • NPI 1962456764

  Clinical

  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1609606565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7317 N WILLOW LAKE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148227",
            "telephone_number": "309-683-7272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7317 N WILLOW LAKE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148227",
            "telephone_number": "309-683-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCIARELLI",
        "first_name": "KARA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "PHD, NCSP, LCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071011250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Guoxiang Chu, MD
• Jamie M Chu, PHARM.D.
• Snigda Chukka, M.D.
• Ryder Michael Church, D.C.
• Anna Cicciarelli, APN
• Scott Joseph Cicciarelli Jr.
• Sarah Cimei, PHARMD
• Brynn N Cinnamon, APN/CNP
• Gabriela Ciofoaia, M.D.
• Ciwirc ( Central Illinois Work Injury Resource Center )

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.