Organization Active NPI

Kelly Behrends, PSYD, PC

  • Clinical Psychologist
  • Libertyville, IL
National Provider Identifier
1962632463
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071.007337 Issued in IL
Legal business name
KELLY BEHRENDS, PSYD, PC
Practice address
1248 American Way
Libertyville, IL 60048-3936
Phone
(224) 433-6744
Fax
(224) 433-6998
NPI assigned
Jul 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Authorized official

Name
Dr. Kelly Jennette Behrends, PSYDNPI 1598809113
Title
President
Phone
(847) 754-5570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 071.007337 IL Primary

Addresses

Primary practice location

1248 American Way
Libertyville, IL 60048-3936

Mailing address

1248 American Way
Suite B
Libertyville, IL 60048-3936
Phone (224) 433-6744

Other practice location 1

970 Harris Rd Unit 1C
Grayslake, IL 60030-3571
Phone (224) 433-6744

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090729000897 IL Part B Supplier - Clinic/Group Practice 5991858516 Receives reassigned benefits from 4 practitioners
Practice locations: Grayslake, IL; Libertyville, IL

National Provider Directory

National Provider Directory

Locations

970 Harris Rd
Unit 1C
Grayslake, IL 60030
Phone 2244336744 ext. 0

1248 American Way
Ste B
Libertyville, IL 60048
Phone (847) 302-6488

1248 American Way
Libertyville, IL 60048
Phone (224) 433-6744

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1962632463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1248 AMERICAN WAY",
            "address_2": "SUITE B",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "224-433-6744",
            "fax_number": "224-433-6998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1248 AMERICAN WAY",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483936",
            "telephone_number": "224-433-6744",
            "fax_number": "224-433-6998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "970 Harris Rd Unit 1C",
            "address_purpose": "LOCATION",
            "city": "Grayslake",
            "state": "IL",
            "postal_code": "600303571",
            "country_code": "US",
            "telephone_number": "224-433-6744",
            "fax_number": "224-433-6998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELLY BEHRENDS, PSYD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-17",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "BEHRENDS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JENNETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-754-5570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.