Organization Active NPI

Prairie Psychotherapy Associates, PC

  • Clinical Social Worker
  • Springfield, IL
National Provider Identifier
1922010537
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
PRAIRIE PSYCHOTHERAPY ASSOCIATES, PC
Practice address
1941 S Spring St
Springfield, IL 62704-3943
Phone
(217) 544-1632
Fax
(217) 544-4543
NPI assigned
Aug 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Lark N Kirchner, LCSW
Title
President
Phone
(217) 544-1632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X IL Primary

Addresses

Primary practice location

1941 S Spring St
Springfield, IL 62704-3943

Mailing address

1941 S Spring St
Springfield, IL 62704-3943
Phone (217) 544-1632

National Provider Directory

National Provider Directory

Locations

1129 S 2nd St
Springfield, IL 62704
Phone (217) 544-1632

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922010537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 S SPRING ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043943",
            "telephone_number": "217-544-1632",
            "fax_number": "217-544-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 S SPRING ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627043943",
            "telephone_number": "217-544-1632",
            "fax_number": "217-544-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE PSYCHOTHERAPY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KIRCHNER",
        "authorized_official_first_name": "LARK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-544-1632",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.