Individual provider Active NPI

Rachel Elizabeth Smith, PSYD, MA, NCC

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1801300439
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.009661 Issued in IL
Practice address
2950 W Chicago Ave Ste 202
Chicago, IL 60622-4377
Phone
(773) 627-2112
NPI assigned
Nov 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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 071.009661 IL Primary

Addresses

Primary practice location

2950 W Chicago Ave Ste 202
Chicago, IL 60622-4377

Mailing address

2950 W Chicago Ave Ste 202
Chicago, IL 60622-4377

Other practice location 1

25 E Washington St Ste 1118
Chicago, IL 60602-1744
Phone (773) 627-2112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
071.009661ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Agave Studio, LLC Clinical Past Accepting new patients
Hearthstone Psychology PLLC Clinical PastSince Apr 6, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1801300439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 W CHICAGO AVE STE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 W CHICAGO AVE STE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224377",
            "telephone_number": "773-627-2112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 E Washington St Ste 1118",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606021744",
            "country_code": "US",
            "telephone_number": "773-627-2112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSYD, MA, NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.