Individual provider Active NPI

Moira Ann Clair Dammrich, PSY.D.

  • Mental Health Counselor
  • Lombard, IL
National Provider Identifier
1629138839
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
246 E Janata Blvd
Suite 112
Lombard, IL 60148-5317
Phone
(630) 424-8900
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA Primary

Addresses

Primary practice location

246 E Janata Blvd
Suite 112
Lombard, IL 60148-5317

Mailing address

950 W Monroe St
Unit 510
Chicago, IL 60607-2788
Phone (312) 385-0460

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gregory Malo PSYD & Associates in Neuropsychology PC PastSince Mar 4, 2009 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1629138839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 W MONROE ST",
            "address_2": "UNIT 510",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072788",
            "telephone_number": "312-385-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 E JANATA BLVD",
            "address_2": "SUITE 112",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485317",
            "telephone_number": "630-424-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMMRICH",
        "first_name": "MOIRA",
        "middle_name": "ANN CLAIR",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.