Individual provider Active NPI

Carolina Mercedes Garcia-Leahy, PH.D.

  • Clinical Psychologist
  • Lake Bluff, IL
National Provider Identifier
1861762734
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.008275 Issued in IL
Practice address
900 N Shore Dr Ste 281
Lake Bluff, IL 60044-2210
Phone
(224) 424-3087
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Psychologist 103TH0004X 071.008275 IL
Clinical Psychologist 103TC0700X 071.008275 IL Primary

Addresses

Primary practice location

900 N Shore Dr Ste 281
Lake Bluff, IL 60044-2210

Mailing address

900 N Shore Dr Ste 281
Lake Bluff, IL 60044-2210
Phone (224) 424-3087

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
I20121103000032 IL Practitioner - Clinical Psychologist 4385895119 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cognizant Psychological Services PLLCGroup PAC ID 0749533032, 2 clinicians

Practice addresses (Care Compare)

900 N Shore Dr
Suite 281
Lake Bluff, IL 60044-2210
Phone (312) 399-5027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.008275ILMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Medicine Clinic Past Accepting new patients
Rehabilitation Medicine Clinic, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1861762734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N SHORE DR STE 281",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442210",
            "telephone_number": "224-424-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N SHORE DR STE 281",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "600442210",
            "telephone_number": "224-424-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA-LEAHY",
        "first_name": "CAROLINA",
        "middle_name": "MERCEDES",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": "071.008275",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Bluff, IL

Sources for this page

Verify at the official NPI Registry.