Active NPI
Katherine Ancell
- School Psychologist
- Carbondale, IL
National Provider Identifier
1811415797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 781132
- Practice address
- 925 S Giant City Rd
Carbondale, IL 62902-5056 - Phone
- (618) 457-3591
- NPI assigned
- Aug 31, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 781132 | IL | Primary |
Addresses
Primary practice location
925 S Giant City Rd
Carbondale, IL 62902-5056
Mailing address
72 Scotty Dr
Carbondale, IL 62903-7360
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 781132 | IL | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carbondale Elem SCH Dist 95 | Past | Accepting new patients | |
| Carbondale Elem School | Past | 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 and National Provider Directory roles.
-
- Student Health Clinic/Center
- Carbondale, IL
- NPI 1225156144
-
- Student Health Clinic/Center
- Carbondale, IL
- NPI 1972774156
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504137600000",
"number": "1811415797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 SCOTTY DR",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629037360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 S GIANT CITY RD",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629025056",
"telephone_number": "618-457-3591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANCELL",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-31",
"last_updated": "2017-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "IL",
"license": "781132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.