Organization Active NPI

McClymonds Psychological Services

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1649792078
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009367 Issued in IL
Legal business name
MCCLYMONDS PSYCHOLOGICAL SERVICES
Doing business as
McClymonds Psychological Services
Practice address
55 E Monroe St Ste 3800
Chicago, IL 60603-6030
Phone
(312) 881-6296
NPI assigned
Jul 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Authorized official

Name
James McCylmonds, PSY. D.
Title
Owner
Phone
(312) 881-6296

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071.009367 IL Primary
Health Service PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TH0100X 20042930A IL

Addresses

Primary practice location

55 E Monroe St Ste 3800
Chicago, IL 60603-6030

Mailing address

55 E Monroe St Ste 3800
Chicago, IL 60603-6030

Other names 1

  • McClymonds Psychological Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190501002000 IL Part B Supplier - Clinic/Group Practice 5597007112 Receives reassigned benefits from 3 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

205 W Randolph St
Ste 2201
Chicago, IL 60606
Phone (312) 348-6296

Practitioners & affiliated clinicians

Practitioners 3

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": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1649792078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E MONROE ST STE 3800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E MONROE ST STE 3800",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606036030",
            "telephone_number": "312-881-6296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLYMONDS PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "MCCYLMONDS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-881-6296",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009367",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Health Service",
            "state": "IL",
            "license": "20042930A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McClymonds Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McClymonds Psychological Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.