Vinita Menon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008186 Issued in IL

Practice address

1400 State St
Ottawa, IL 61350-4735

Phone

(815) 421-9010

NPI assigned

Jun 15, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vinitamenon@tdh.allscriptsdirect.net

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.

• Thrive Collective

  • Clinical Psychologist
  • Ottawa, IL
  • NPI 1396345906
  NPD
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567
  NPD
• The Plains Clinic

  • Child & Adolescent Psychiatry Physician
  • Geneva, IL
  • NPI 1215652011
  NPD (past)

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1750644688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4N204 FOX MILL BLVD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601757768",
            "telephone_number": "630-222-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 STATE ST",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613504735",
            "telephone_number": "815-421-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENON",
        "first_name": "VINITA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "2391453",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Ottawa",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Ottawa",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Ottawa",
            "address_1": "1400 State St",
            "city": "Ottawa",
            "state": "IL",
            "country_code": "US",
            "postal_code": "613504735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meghan McNamara
• Leo John Meagher, MA PSYCHOLOGY
• Medi-RX Pharmacy, Inc
• Medical Care Innovation, P.C.
• Kelsi Mendez, PMHNP
• Andrea Meyer, MA
• Midwest Emergency Northern Illinois Inc
• Marianne Mikat Stevens, MD
• Milestones Pediatric Therapy Inc.
• Daniel Jon Miller, DC

• Clinical Psychologist in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.