Individual provider Active NPI

Ara Joann Rose Lambert, PSYD

  • Clinical Psychologist
  • Bloomington, IL
National Provider Identifier
1649762667
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071010390 Issued in IL
Practice address
808 S Eldorado Rd Ste 102
Bloomington, IL 61704-6075
Phone
(309) 706-3190
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1198 WV
Clinical Psychologist 103TC0700X 071010390 IL Primary

Addresses

Primary practice location

808 S Eldorado Rd Ste 102
Bloomington, IL 61704-6075

Mailing address

1007 Arlene CT Apt 12
Bloomington, IL 61701-7175
Phone (309) 830-4438

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210203000775 IL Practitioner - Clinical Psychologist 8123376860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

808 S Eldorado Rd
Suite 102
Bloomington, IL 61704-6075
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071010390ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. CurrentSince Aug 7, 2023 Accepting new patients

Locations

808 S Eldorado Rd
Ste 300
Bloomington, IL 61704
Phone (309) 827-2962

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

3027 English Rows Ave
Ste 201
Naperville, IL 60564

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.aralambert@146897.advancedmd-direct.com

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1649762667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 ARLENE CT APT 12",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617017175",
            "telephone_number": "309-830-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD STE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046075",
            "telephone_number": "309-706-3190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMBERT",
        "first_name": "ARA",
        "middle_name": "JOANN ROSE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "1198",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.