Ivy Psychotherapy, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

IVY PSYCHOTHERAPY, PLLC

Practice address

912 W Hill St
Champaign, IL 61821-2706

Phone

(217) 863-1997

Fax

(205) 896-0038

NPI assigned

Oct 19, 2026

Last updated

Nov 1, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samantha Ege

Title

Owner

Phone

(630) 674-8365

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1792368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793491200000",
    "number": "1720984404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 W HILL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212706",
            "telephone_number": "217-863-1997",
            "fax_number": "205-896-0038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W HILL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212706",
            "telephone_number": "217-863-1997",
            "fax_number": "205-896-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IVY PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-11-01",
        "certification_date": "2026-11-01",
        "status": "A",
        "authorized_official_last_name": "EGE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-674-8365"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Champaign, IL
• Providers in Champaign, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2026; 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.