Starved Rock Family Psychiatry, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

STARVED ROCK FAMILY PSYCHIATRY, LLC

Practice address

325 Clark St Ste C
Utica, IL 61373-9484

Phone

(815) 275-3035

NPI assigned

Apr 2, 2024

Organization subpart

No

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

Authorized official

Name

Amanda Amiti, PMHNP

Title

Owner

Phone

(815) 275-3035

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1861244063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRIDGET TER",
            "city": "UTICA",
            "state": "IL",
            "postal_code": "613739552",
            "telephone_number": "815-275-3035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CLARK ST STE C",
            "city": "UTICA",
            "state": "IL",
            "postal_code": "613739484",
            "telephone_number": "815-275-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARVED ROCK FAMILY PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-02",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "AMITI",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-275-3035",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole B Kowalczyk, LCPC
• Michael Kenneth Nelson, LCSW
• Premise Health of Illinois Medical PC
• Mahmoud Salameh, DMD
• Jami Lynn Sebastian, SLP
• Jorie Swingel, FNP
• Jessica Turczyn, NP-C
• Utica Fire Protection District
• Waltham C C School Dist 185
• Jennifer Westbrook, A.P.N.

• All providers in Utica, IL
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.