NPIMap

Individual provider Active NPI

Carey Jeanne Woodruff, PH.D.

  • Clinical Neuropsychologist
  • Lake Forest, IL
National Provider Identifier
1871727305
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
071007667 Issued in IL
Practice address
222 E Wisconsin Ave Ste 108
Lake Forest, IL 60045-1700
Phone
(877) 570-7970
Fax
(877) 570-7970
NPI assigned
May 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071007667 IL
Rehabilitation Psychologist 103TR0400X 071007667 IL
Clinical Neuropsychologist 103G00000X 071007667 IL Primary

Addresses

Primary practice location

222 E Wisconsin Ave Ste 108
Lake Forest, IL 60045-1700

Mailing address

14655 Westwoods LN
Libertyville, IL 60048-9404
Phone (847) 942-9084

Other names 1

  • Dr. Carey Jeanne Walmsley Former name

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071007667ILMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert M Pasen PHD PC Clinical Past Accepting new patients
Neurobehavioral Health Connections, LTD Clinical Past Accepting new patients
Hilltop Haven Inc Clinical Neuropsychologist 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": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1871727305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14655 WESTWOODS LN",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600489404",
            "telephone_number": "847-942-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E WISCONSIN AVE STE 108",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451700",
            "telephone_number": "877-570-7970",
            "fax_number": "877-570-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "CAREY",
        "middle_name": "JEANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007667",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "IL",
            "license": "071007667",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071007667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAREY",
            "last_name": "WALMSLEY",
            "middle_name": "JEANNE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.