Individual provider Active NPI

Christina Samycia, PSYD

  • Counseling Psychologist
  • Chicago, IL
National Provider Identifier
1710217310
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
071007818 Issued in IL
Practice address
77 W Washington St Ste 1519
Chicago, IL 60602-3223
Phone
(312) 285-5287
Fax
(312) 345-1551
NPI assigned
Jan 4, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 071007818 IL Primary

Addresses

Primary practice location

77 W Washington St Ste 1519
Chicago, IL 60602-3223

Mailing address

77 W Washington St Ste 1519
Chicago, IL 60602-3223
Phone (312) 285-5287

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
I20120323000387 IL Practitioner - Clinical Psychologist 4082874391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

77 W Washington St
Suite 1118
Chicago, IL 60602-3256
Phone (312) 285-5287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071007818ILMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina Samycia PSYD, LTD. CurrentSince Jan 21, 2017 Accepting new patients
Associated Psychologists Past Accepting new patients

Locations

77 W Washington St
Ste 1118
Chicago, IL 60602
Phone (312) 285-5287

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1710217310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W WASHINGTON ST STE 1519",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023223",
            "telephone_number": "312-285-5287",
            "fax_number": "312-345-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W WASHINGTON ST STE 1519",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023223",
            "telephone_number": "312-285-5287",
            "fax_number": "312-345-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMYCIA",
        "first_name": "CHRISTINA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IL",
            "license": "071007818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.