Organization Active NPI

Donna Lettieri-Marks, Psy.D., LTD

  • Adult Mental Health Clinic/Center
  • Naperville, IL
National Provider Identifier
1649418518
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
071-005423 Issued in IL
Legal business name
DONNA LETTIERI-MARKS, PSY.D., LTD
Practice address
55 S Main St
Suite 371
Naperville, IL 60540-5372
Phone
(630) 904-6610
Fax
(630) 544-3429
NPI assigned
Jan 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Authorized official

Name
Dr. Donna Lettieri-Marks, PSY.D.NPI 1346233665
Title
Clinical Psychologist/Owner
Phone
(630) 904-6610

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 071-005423 IL Primary

Addresses

Primary practice location

55 S Main St
Suite 371
Naperville, IL 60540-5372

Mailing address

55 S Main St
Suite 371
Naperville, IL 60540-5372
Phone (630) 904-6610

Other identifiers 2

IdentifierTypeStateIssuer
1346233665OtherNPI (INDIVIDUAL TYPE I NUMBER)
357980OtherILMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090604000222 IL Part B Supplier - Clinic/Group Practice 6800946344 Receives reassigned benefits from 1 practitioner
Practice locations: Naperville, IL

National Provider Directory

National Provider Directory

Locations

55 S Main St
Ste 371
Naperville, IL 60540
Phone (630) 904-6610

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1233187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233187200000",
    "number": "1649418518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 S MAIN ST",
            "address_2": "SUITE 371",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405372",
            "telephone_number": "630-904-6610",
            "fax_number": "630-544-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 S MAIN ST",
            "address_2": "SUITE 371",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405372",
            "telephone_number": "630-904-6610",
            "fax_number": "630-544-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONNA LETTIERI-MARKS, PSY.D., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-29",
        "last_updated": "2009-01-29",
        "status": "A",
        "authorized_official_last_name": "LETTIERI-MARKS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "630-904-6610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "071-005423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (INDIVIDUAL TYPE I NUMBER)",
            "identifier": "1346233665",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "357980",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.