NPIMap

Organization Active NPI

Willoughby Center for Behavioral Health, LLC

  • Clinical Psychologist
  • Evanston, IL
National Provider Identifier
1700257581
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008303 Issued in IL
Legal business name
WILLOUGHBY CENTER FOR BEHAVIORAL HEALTH, LLC
Practice address
1603 Orrington Ave.
Ste. 600
Evanston, IL 60201
Phone
(224) 585-3312
Fax
(224) 585-3619
NPI assigned
Oct 19, 2015
Last updated
Apr 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Authorized official

Name
Dr. Cindi-Marie Willoughby, PSY. D.NPI 1487929345
Title
Clinical Psychologist
Phone
(773) 814-1445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071.008303 IL Primary

Addresses

Primary practice location

1603 Orrington Ave.
Ste. 600
Evanston, IL 60201

Mailing address

1603 Orrington Ave Ste 600
Evanston, IL 60201-3860
Phone (224) 585-3312

Other practice location 1

1440 Renaissance Dr Ste 125
Park Ridge, IL 60068-1414
Phone (224) 585-3312

National Provider Directory

National Provider Directory

Locations

824 S Main St
Ste 201
Crystal Lake, IL 60014
Phone (224) 585-3312

1440 Renaissance Dr
Ste 125
Park Ridge, IL 60068
Phone (224) 585-3312

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1700257581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 ORRINGTON AVE STE 600",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602013860",
            "telephone_number": "224-585-3312",
            "fax_number": "224-585-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 ORRINGTON AVE.",
            "address_2": "STE. 600",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "60201",
            "telephone_number": "224-585-3312",
            "fax_number": "224-585-3619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1440 Renaissance Dr Ste 125",
            "address_purpose": "LOCATION",
            "city": "Park Ridge",
            "state": "IL",
            "postal_code": "600681414",
            "country_code": "US",
            "telephone_number": "224-585-3312",
            "fax_number": "224-585-3619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLOUGHBY CENTER FOR BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "WILLOUGHBY",
        "authorized_official_first_name": "CINDI-MARIE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "773-814-1445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY. D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; 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.