Unknown Individual – Clinical Psychologist, NPI 1013974765
Clinical Psychologist
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
3716, West Brighton Avenue, Peoria, Peoria County, Illinois, 61615, United States
PEORIA, IL 61615
Phone: (309) 692-7755
Fax: (309) 692-2262
Mailing address matches the actual address.
NPPES updates history
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Medicare Enrollment & Revalidation
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Medicare Utilization (FFS)
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Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 223 | 18 | $0 |
Insurance plans in this area (ZIP 61615)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | IL | |
| Mental Health Counselor | IL | |
| - | IL | |
| Mental Health Counselor | IL | |
| Mental Health Counselor | IL | |
| Clinical Social Worker | IL | |
| Mental Health Counselor | IL | |
| Clinical Psychologist | IL | |
| Clinical Psychologist | IL | |
| Mental Health Counselor | IL |
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