Crystal Carroll, MA
Individual provider Active NPI School Psychologist · Watseka, IL
NPI 1740413442 · NPPES record last updated Aug 27, 2009
Key facts
- NPI
- 1740413442
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 323 W Mulberry St
Watseka, IL 60970-1568 - Phone
- (815) 432-5241
- Fax
- (815) 432-4537
- NPI assigned
- Aug 27, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
323 W Mulberry St
Watseka, IL 60970-1568
Mailing address
323 W Mulberry St
Watseka, IL 60970-1568
Phone (815) 432-5241
Other providers in Watseka, IL
- Susan Joyce Bunting
- Nicholas J Burns
- Alberta B Burton
- William R Burwell
- Jennifer Bushey
- Catriese Carson Jackson
- Cassandra Jean Chaplinski
- City of Watseka
- Michael Clary
- Amy M. Creek
All providers in Watseka, IL · School Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.