SOUTHPARK PSYCHOLOGY LTD
NPI 1558470419
Psychologist - Counseling in Moline, IL
About Southpark Psychology Ltd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHPARK PSYCHOLOGY LTD (NPI 1558470419) is a healthcare organization registered as a counseling in Moline, Illinois and active in the NPI registry since August 2006. The organization lists Carl Vincent, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southpark Psychology Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
21Medicare enrollment records show 21 clinicians reassign Medicare billing to Southpark Psychology Ltd, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 14 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 4
Nearest to this location (20)
See all 21Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Southpark Psychology Ltd's NPI number?
The NPI number for Southpark Psychology Ltd is 1558470419. It was assigned to this organization in the NPPES registry on August 30, 2006.
Where is Southpark Psychology Ltd located?
Southpark Psychology Ltd is located at 2100 52nd Ave, Moline, IL 61265. The listed phone number is (309) 797-2900.
What is Southpark Psychology Ltd's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Counseling, with taxonomy code 103TC1900X.
Is Southpark Psychology Ltd enrolled in Medicare?
Yes. Southpark Psychology Ltd is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southpark Psychology Ltd?
According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 4 Medicare specialties reassign their Medicare billing to Southpark Psychology Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (11), Clinical Social Worker (7) and Clinical Psychologist (2). Of these, 5 practice at this address and 14 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southpark Psychology Ltd accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Southpark Psychology Ltd as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southpark Psychology Ltd was last updated on January 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.