Individual provider Active NPI

Julie A Peterson, PSY.D.

  • Clinical Psychologist
  • Hinsdale, IL
National Provider Identifier
1689015992
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071009559 Issued in IL
Practice address
15 Spinning Wheel Rd Ste 426
Hinsdale, IL 60521-7671
Phone
(630) 634-8526
Fax
(630) 323-3058
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Clinical Psychologist 103TC0700X 071009559 IL Primary

Addresses

Primary practice location

15 Spinning Wheel Rd Ste 426
Hinsdale, IL 60521-7671

Mailing address

15 Spinning Wheel Rd Ste 426
Hinsdale, IL 60521-7671
Phone (630) 634-8526

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
I20180425001567 IL Practitioner - Clinical Psychologist 5799049896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Lodestone Center for Behavioral Health PCGroup PAC ID 6709128317, 27 clinicians

Practice addresses (Care Compare)

15 Spinning Wheel Rd
Suite 426
Hinsdale, IL 60521-7671
Phone (847) 854-4058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071009559ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Family Institute Clinical CurrentSince Mar 19, 2018 Accepting new patients
The Lodestone Center for Behavioral Health, PC Marriage & Family Therapist CurrentSince Nov 2, 2020 Accepting new patients
TMS Psychological Services PC Clinical PastSince Sep 1, 2017 Accepting new patients

Locations

618 Library Pl
Evanston, IL 60201
Phone (312) 609-5300

15 Spinning Wheel Rd
Ste 426
Hinsdale, IL 60521
Phone (630) 323-3050

666 Dundee Rd
Ste 1501
Northbrook, IL 60062
Phone (847) 733-4300

111 Dean St
Woodstock, IL 60098
Phone (815) 344-5061

Interoperability endpoints

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

Organizations & group practices 3

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1689015992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 SPINNING WHEEL RD STE 426",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605217671",
            "telephone_number": "630-634-8526",
            "fax_number": "630-323-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SPINNING WHEEL RD STE 426",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605217671",
            "telephone_number": "630-634-8526",
            "fax_number": "630-323-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JULIE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.