Thomas Lloyd Slattery, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071008362 Issued in IL

Practice address

808 S Eldorado Rd
Suite 102
Bloomington, IL 61704-6071

Phone

(309) 310-4636

Fax

(309) 588-4115

NPI assigned

May 23, 2012

Sex

Male

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)

Enrolled

Practice roles

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.

• Three Birds Mental Health Services PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Sycamore, IL
  • NPI 1144141870
  NPD (past)

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1821358987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD",
            "address_2": "SUITE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046071",
            "telephone_number": "309-310-4636",
            "fax_number": "309-588-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S ELDORADO RD",
            "address_2": "SUITE 102",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046071",
            "telephone_number": "309-310-4636",
            "fax_number": "309-588-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "THOMAS",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071008362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Simmons
• Kaysha Simpson, HIS
• Justine Sims, APN, CNM
• Ashish Singal, MD/PHD,MS,MBA,NREMT
• Alyssa Ann Skelton
• Sleep Center of Central Illinois LLC
• Sleep Solutions of Central Illinois
• Sleep Solutions of Central Illinois LLC
• Sarah Sleeter, MS, CCC-SLP
• Barry Slotky, MD

• Psychologist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.