Taylor Lindbom, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071010651 Issued in IL

Practice address

100 N Chestnut St Ste 244
Champaign, IL 61820-4872

Phone

(217) 621-6180

NPI assigned

Nov 11, 2021

Last updated

Nov 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Graceway Psychology Group, LLC

  • Clinical Psychologist
  • Champaign, IL
  • NPI 1275900896
  NPD (past)

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1790441939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N CHESTNUT ST STE 244",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204872",
            "telephone_number": "217-621-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N CHESTNUT ST STE 244",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618204872",
            "telephone_number": "217-621-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBOM",
        "first_name": "TAYLOR",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071010651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Todd Lighty, LSW
• Huiyi Lin, RN
• Carmen Linares
• Lincare Inc.
• Linda Miller, LCSW
• Lindsey a Hans, DMD LTD
• Lindsey Adult Day Services, Inc. (Circle of Friends Adult Day Center)
• Lindsey Senior Solutions LLC (Circle of Friends Adult Day Center)
• Chelsea Link, COTA/L
• Coreya Lipscomb, RBT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.