SOUTHERN ILLINOIS UNIVERSITY CARBONDALE CLINICAL CENTER
NPI 1174919351
Psychologist in Carbondale, IL

Active since April 14, 2015
625 WHAM DRIVE ROOM 141, CARBONDALE, IL 62901(618) 453-2361(618) 453-6130 Get Directions Write a Review

NPPES record last updated: April 14, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southern Illinois University Carbondale Clinical Center NPPES

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

SOUTHERN ILLINOIS UNIVERSITY CARBONDALE CLINICAL CENTER (NPI 1174919351) is a healthcare organization registered as a psychologist in Carbondale, Illinois and active in the NPI registry since April 2015. The organization lists Holly Cormier, Director, as its authorized official.

NPPES Registry Identity

NPI1174919351
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameSOUTHERN ILLINOIS UNIVERSITY CARBONDALE CLINICAL CENTER
Location Address625 WHAM DRIVE ROOM 141Carbondale, IL 62901
Mailing Address625 Wham Drive Room 141Carbondale, IL 62901 · (618) 453-2361 · Fax (618) 453-6130
Fax(618) 453-6130
Organization SubpartYesParent: Southern Illinois University Carbondale
Authorized OfficialHolly CormierDirector · (618) 453-2361
Enumeration DateApril 14, 2015
NPI 1174919351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · CounselingTaxonomy 103TC1900X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedSpeech-Language PathologistTaxonomy 235Z00000X
625 WHAM DRIVE ROOM 141, Carbondale, IL 62901

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

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

Speech-Language Pathologist
625 WHAM DRIVE ROOM 141, SIUC CLINICAL CENTER
CARBONDALE, IL 62901

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 Southern Illinois University Carbondale Clinical Center's NPI number?

The NPI number for Southern Illinois University Carbondale Clinical Center is 1174919351. It was assigned to this organization in the NPPES registry on April 14, 2015.

Where is Southern Illinois University Carbondale Clinical Center located?

Southern Illinois University Carbondale Clinical Center is located at 625 Wham Drive Room 141, Carbondale, IL 62901. The listed phone number is (618) 453-2361.

What is Southern Illinois University Carbondale Clinical Center's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Southern Illinois University Carbondale Clinical Center was last updated on April 14, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.