Individual provider Active NPI

Carolyn I Werneke, PSY.D.

  • School Psychologist
  • St Charles, IL
National Provider Identifier
1952317588
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
1395103 Issued in IL
Practice address
409 Illinois Ave
Suite 1-a
St Charles, IL 60174-2966
Phone
(630) 421-7260
Fax
(630) 513-0919
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 1395103 IL Primary
Clinical Psychologist 103TC0700X IL

Addresses

Primary practice location

409 Illinois Ave
Suite 1-a
St Charles, IL 60174-2966

Mailing address

601 Chesapeake Rd
St Charles, IL 60175-5632
Phone (630) 421-7260

Other identifiers 1

IdentifierTypeStateIssuer
04523149OtherILBLUE CROSS BLUE SHIELD

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071-005613ILMDClinical Psychologist
1395103ILMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1952317588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 CHESAPEAKE RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601755632",
            "telephone_number": "630-421-7260",
            "fax_number": "630-513-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 ILLINOIS AVE",
            "address_2": "SUITE 1-A",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601742966",
            "telephone_number": "630-421-7260",
            "fax_number": "630-513-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNEKE",
        "first_name": "CAROLYN",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "1395103",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "04523149",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.