Individual provider Active NPI

Adrienne A Skinner, PSYD

  • Clinical Psychologist
  • Naperville, IL
National Provider Identifier
1790880201
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071007049 Issued in IL
Practice address
120 S Webster St Ste 203
Naperville, IL 60540-4477
Phone
(815) 407-7236
Fax
(630) 984-6608
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007049 IL Primary

Addresses

Primary practice location

120 S Webster St Ste 203
Naperville, IL 60540-4477

Mailing address

120 S Webster St Ste 203
Naperville, IL 60540-4477
Phone (630) 984-6608

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
I20080813000862 IL Practitioner - Clinical Psychologist 0042381881 Practice locations: Naperville, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

120 S Webster St
Suite 203
Naperville, IL 60540-4479
Phone (630) 984-6608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071007049ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Beth McLaughlin,LTD Past Accepting new patients

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1790880201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S WEBSTER ST STE 203",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404477",
            "telephone_number": "630-984-6608",
            "fax_number": "630-984-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S WEBSTER ST STE 203",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605404477",
            "telephone_number": "815-407-7236",
            "fax_number": "630-984-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "ADRIENNE",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.