DR. REBEKAH LEE FULLER FRICKE PSYD
NPI 1568763977
Psychologist - Clinical in Champaign, IL

Q: What is Rebekah Fuller Fricke's NPI number?

The NPI number for Rebekah Fuller Fricke is 1568763977. It was assigned to this individual provider in the NPPES registry on November 16, 2010.

Q: What is Rebekah Fuller Fricke's specialty?

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

Q: Is Rebekah Fuller Fricke enrolled in Medicare?

No. Rebekah Fuller Fricke has opted out of Medicare through July 14, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since November 16, 2010Opted out of Medicare · through Jul 14, 2028

100 N CHESTNUT ST STE 244, CHAMPAIGN, IL 61820(217) 621-6180 Get Directions Write a Review

NPPES record last updated: September 8, 2016. Verified against the NPPES registry weekly; last sync: September 27, 2026.

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About Dr. Rebekah Lee Fuller Fricke Psyd NPPES

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

DR. REBEKAH LEE FULLER FRICKE PSYD (NPI 1568763977) is an individual clinical provider in Champaign, Illinois, licensed in Illinois (071008014) and active in the NPI registry since November 2010. She has opted out of Medicare through July 14, 2028.

NPPES Registry Identity

NPI1568763977

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. REBEKAH LEE FULLER FRICKECredential: PSYD

Location Address100 N CHESTNUT ST STE 244Champaign, IL 61820-4856

Mailing AddressPo Box 2257Chesterton, IN 46304-0357 · (219) 926-8320 · Fax (219) 926-3524

Phone(217) 621-6180

Sole ProprietorNo

Enumeration DateNovember 16, 2010

Last NPPES UpdateSeptember 8, 2016

✔ NPI 1568763977 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071008014

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.

100 N CHESTNUT ST STE 244, Champaign, IL 61820

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Rebekah Lee Fuller Fricke Psyd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 14, 2020 through July 14, 2028.

Opt-Out Effective DateJuly 14, 2020

Opt-Out In Effect ThroughJuly 14, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

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

CODY S LEWIS COUNSELING LTD

Social Worker (Clinical)

100 N CHESTNUT ST STE 244
CHAMPAIGN, IL 61820

Champaign County (217) 402-4877

ROBYN LATRICE GOBIN PH.D.

Psychologist

100 N CHESTNUT ST STE 244
CHAMPAIGN, IL 61820

Champaign County (217) 621-6180

SHARON GRIFFIN PH.D.

Psychologist (Clinical)

100 N CHESTNUT ST STE 244
CHAMPAIGN, IL 61820

Champaign County (217) 493-6366

TAYLOR LINDBOM PSYD

Psychologist (Clinical)

100 N CHESTNUT ST STE 244
CHAMPAIGN, IL 61820

Champaign County (217) 621-6180

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 Rebekah Fuller Fricke's NPI number?

The NPI number for Rebekah Fuller Fricke is 1568763977. It was assigned to this individual provider in the NPPES registry on November 16, 2010.

Where is Rebekah Fuller Fricke located?

Rebekah Fuller Fricke practices at 100 N Chestnut St Ste 244, Champaign, IL 61820. The listed phone number is (217) 621-6180.

What is Rebekah Fuller Fricke's specialty?

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

Is Rebekah Fuller Fricke enrolled in Medicare?

No. Rebekah Fuller Fricke has opted out of Medicare through July 14, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Rebekah Fuller Fricke was last updated on September 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.