Individual provider Active NPI

Matthew Harings, PSYD, MSCP

  • Clinical Child & Adolescent Psychologist
  • Chicago, IL
National Provider Identifier
1679158430
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
071.010493 Issued in IL
Practice address
2502 N Clark St Ste 212
Chicago, IL 60614-1850
Phone
(773) 930-9553
NPI assigned
Mar 13, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 071.010493 IL Primary

Addresses

Primary practice location

2502 N Clark St Ste 212
Chicago, IL 60614-1850

Mailing address

2502 N Clark St Ste 212
Chicago, IL 60614-1850
Phone (773) 930-9553

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
I20210726000178 IL Practitioner - Clinical Psychologist 5395148621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2502 N Clark St
Suite 212
Chicago, IL 60614-1850
Phone (773) 930-9553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Behavioral Health P.C. CurrentSince May 1, 2021 Accepting new patients
Symed, Inc. PastSince Aug 4, 2024 Accepting new patients

Locations

2502 N Clark St
Ste 212
Chicago, IL 60614
Phone (773) 477-8991

4711 Golf Rd
Ste 400
Skokie, IL 60076
Phone (847) 679-3040

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1679158430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 N CLARK ST STE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141850",
            "telephone_number": "773-930-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 N CLARK ST STE 212",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141850",
            "telephone_number": "773-930-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARINGS",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "PSYD, MSCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-13",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071.010493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.