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PCPA LEGACY, LLC
NPI 1093030132
Psychologist - Clinical in Northbrook, IL

Active since April 01, 2010
400 SKOKIE BLVD STE 245, NORTHBROOK, IL 60062(847) 630-1611(847) 446-4673 Get Directions Write a Review

NPPES record last updated: September 6, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 6, 2023, Oct 27, 2022 (2 updates tracked since 2022).

About Pcpa Legacy, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PCPA LEGACY, LLC (NPI 1093030132), doing business as Primary Care Psychology Assocaites, Llc, is a healthcare organization registered as a clinical in Northbrook, Illinois and active in the NPI registry since April 2010. The organization lists Paul C Kredow, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1093030132
Entity TypeOrganization
Primary Taxonomy103TC0700X
Legal Business NamePCPA LEGACY, LLC
Location Address400 SKOKIE BLVD STE 245Northbrook, IL 60062-7932
Mailing Address400 Skokie Blvd Ste 245Northbrook, IL 60062-7932 · (847) 630-1611 · Fax (847) 446-4673
Phone(847) 630-1611
Fax(847) 446-4673
Organization SubpartNo
Authorized OfficialPaul C KredowProvider/owner · (847) 630-1611
Enumeration DateApril 1, 2010
Last NPPES UpdateSeptember 6, 20232 updates tracked since enumeration
NPPES CertifiedOctober 27, 2022
✔ NPI 1093030132 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in IL · 071-004395
Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Also ListedPsychologist · Clinical Child & AdolescentTaxonomy 103TC2200X · License 071-004395 (IL)
400 SKOKIE BLVD STE 245, Northbrook, IL 60062
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Other Names 2

Former Legal Business NamePrimary Care Psychology Assocaites, Llc
Doing Business AsPcpa Legacy. Llc

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PAUL C KREDOW PSY.D.
Psychologist (Clinical)
400 SKOKIE BLVD STE 245
NORTHBROOK, IL 60062
Cook County (847) 446-4617
LAURA DONNAN LCSW, MPH
Social Worker (Clinical)
400 SKOKIE BLVD STE 245
NORTHBROOK, IL 60062
Cook County (847) 686-0090

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pcpa Legacy, LLC's NPI number?

The NPI number for Pcpa Legacy, LLC is 1093030132. It was assigned to this organization in the NPPES registry on April 1, 2010. The provider is doing business as Pcpa Legacy. LLC. The provider was formerly known as Primary Care Psychology Assocaites, LLC.

Where is Pcpa Legacy, LLC located?

Pcpa Legacy, LLC is located at 400 Skokie Blvd Ste 245, Northbrook, IL 60062. The listed phone number is (847) 630-1611.

What is Pcpa Legacy, LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Pcpa Legacy, LLC was last updated on September 6, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.