PSYCHOLOGY CONNECTION OF NORTH SHORE, LLC
NPI 1558974923
Community/Behavioral Health in Libertyville, IL

Q: What is Psychology Connection Of North Shore, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since August 26, 2020

176 ACORN LN, LIBERTYVILLE, IL 60048(847) 630-9403 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 13, 2022, Oct 25, 2020, Oct 9, 2020 and 2 more (5 updates tracked since 2020).

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About Psychology Connection Of North Shore, Llc NPPES

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

PSYCHOLOGY CONNECTION OF NORTH SHORE, LLC (NPI 1558974923) is a healthcare organization registered as a community/behavioral health in Libertyville, Illinois and active in the NPI registry since August 2020. The organization lists Dorota Domanski-erdman, Owner; Psyd, as its authorized official.

NPPES Registry Identity

NPI1558974923

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NamePSYCHOLOGY CONNECTION OF NORTH SHORE, LLC

Location Address176 ACORN LNLibertyville, IL 60048-2158

Mailing Address176 Acorn LnLibertyville, IL 60048-2158 · (847) 630-9403 · Fax (708) 468-4991

Phone(847) 630-9403

Organization SubpartNo

Authorized OfficialDorota Domanski-erdmanOwner; Psyd · (847) 630-9403

Enumeration DateAugust 26, 2020

Last NPPES UpdateJuly 24, 20255 updates tracked since enumeration

NPPES CertifiedJuly 24, 2025

✔ NPI 1558974923 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

176 ACORN LN, Libertyville, IL 60048

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Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Psychology Connection Of North Shore, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Psychology Connection Of North Shore, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dorota Domanski Erdman, PSYD

Clinical Psychologist

NPI 1033206636

176 ACORN LN
Libertyville, IL 60048

(847) 394-4174

✔ PECOS✔ Accepts MedicareSame address

Source: 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 Psychology Connection Of North Shore, LLC's NPI number?

The NPI number for Psychology Connection Of North Shore, LLC is 1558974923. It was assigned to this organization in the NPPES registry on August 26, 2020.

Where is Psychology Connection Of North Shore, LLC located?

Psychology Connection Of North Shore, LLC is located at 176 Acorn Ln, Libertyville, IL 60048. The listed phone number is (847) 630-9403.

What is Psychology Connection Of North Shore, LLC's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Is Psychology Connection Of North Shore, LLC enrolled in Medicare?

Yes. Psychology Connection Of North Shore, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Psychology Connection Of North Shore, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Psychology Connection Of North Shore, LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Psychology Connection Of North Shore, LLC was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.