Individual provider Active NPI

Melinda D Hammond, PSY.D.

  • Clinical Psychologist
  • Plainfield, IL
National Provider Identifier
1659645711
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009256 Issued in IL
Practice address
13246 S Route 59 # 102a
Plainfield, IL 60585-9800
Phone
(630) 296-7639
NPI assigned
Mar 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180008074 IL
Clinical Psychologist 103TC0700X 071.009256 IL Primary

Addresses

Primary practice location

13246 S Route 59 # 102a
Plainfield, IL 60585-9800

Mailing address

13246 S Route 59 # 102a
Plainfield, IL 60585-9800
Phone (630) 296-7639

Other practice location 1

15127 S 73rd Ave
G
Orland Park, IL 60462-4398
Phone (708) 845-5500

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
I20160616000890 IL Practitioner - Clinical Psychologist 7012208309 Practice locations: Plainfield, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180008074ILMDProfessional Counselor
071.009256ILMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1659645711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13246 S ROUTE 59 # 102A",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605859800",
            "telephone_number": "630-296-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13246 S ROUTE 59 # 102A",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605859800",
            "telephone_number": "630-296-7639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15127 S 73rd Ave",
            "address_2": "G",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604624398",
            "country_code": "US",
            "telephone_number": "708-845-5500",
            "fax_number": "708-845-5505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "MELINDA",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008074",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, IL

Sources for this page

Verify at the official NPI Registry.