Kaleidoscope Center Corp

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

KALEIDOSCOPE CENTER CORP

Doing business as

Kaleidoscope Center For Autism and Neurodevelopment

Practice address

630 Pierce Blvd Ste 300
O Fallon, IL 62269-2583

Phone

(618) 221-9677

NPI assigned

Dec 18, 2023

Organization subpart

No

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

Authorized official

Name

Rachel Minelli, PHDNPI 1780086496

Title

Owner/Clinical Psychologist

Phone

(618) 221-9677

Specialties & licenses 1

Addresses

Other names 1

• Kaleidoscope Center For Autism and Neurodevelopment Doing business as

Locations

Practitioners 1

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

• Rachel Minelli, PH.D.

  • Clinical Psychologist
  • O'Fallon, IL
  • NPI 1780086496
  NPD Authorized official

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1669240867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7020 FAIRBANKS ST",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 PIERCE BLVD STE 300",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692583",
            "telephone_number": "618-221-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDOSCOPE CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-17",
        "status": "A",
        "authorized_official_last_name": "MINELLI",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER/CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "618-221-9677",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kaleidoscope Center For Autism and Neurodevelopment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephen Jubinski Jr., M.D.
• Margaret Renee Judson
• Christianne Meier Judy, MSW, LCSW
• Ellie Junker, RBT
• Kris Kahler
• Lucas Kaliszak
• Karla Smith Foundation (Karla Smith Behavioral Health)
• John Michael Kaschke, MD
• Katie Gibbons Counseling LLC
• Amy Lynn Katsikas, CNS

• Clinical Psychologist in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.