Individual provider Active NPI

Shaciarra Drake, PSYD

  • Psychologist
  • Champaign, IL
National Provider Identifier
1649091380
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
071.011224 Issued in IL
Practice address
701 Devonshire Dr Ste C11
Champaign, IL 61820-7352
Phone
(217) 213-3405
Fax
(214) 403-9557
NPI assigned
Oct 23, 2024
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 071.011224 IL Primary

Addresses

Primary practice location

701 Devonshire Dr Ste C11
Champaign, IL 61820-7352

Mailing address

2702 N Skyline Dr
Urbana, IL 61802-7835
Phone (601) 880-6206

Other names 1

  • Shaciarra Hamilton Former name

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

LicenseStateTypeSpecialty
071.011224ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rooted Pathways Counseling and Consulting CurrentSince Oct 27, 2024 Accepting new patients

Locations

701 Devonshire Dr
Ste C11
Champaign, IL 61820
Phone (217) 213-3405

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1649091380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 N SKYLINE DR",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618027835",
            "telephone_number": "601-880-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR STE C11",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207352",
            "telephone_number": "217-213-3405",
            "fax_number": "214-403-9557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "SHACIARRA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071.011224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHACIARRA",
            "last_name": "HAMILTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2026; 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.