Active NPI
Vicki Renee Reich
- School Psychologist
- Mount Vernon, IL
National Provider Identifier
1619607215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 41171
- Practice address
- 4223 Lilac LN
Mount Vernon, IL 62864-2108 - Phone
- (618) 214-5573
- NPI assigned
- Jun 15, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 41171 | IL | Primary |
Addresses
Primary practice location
4223 Lilac LN
Mount Vernon, IL 62864-2108
Mailing address
4223 Lilac LN
Mount Vernon, IL 62864-2108
Phone (618) 214-5573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41171 | IL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1619607215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4223 LILAC LN",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642108",
"telephone_number": "618-214-5573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4223 LILAC LN",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642108",
"telephone_number": "618-214-5573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REICH",
"first_name": "VICKI",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-06-15",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "41171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.