KELLIE MENTER PHD, LCP, NCSP
NPI 1639054448
Clinical Neuropsychologist in Romeoville, IL

Q: What is Kellie Menter's NPI number?

The NPI number for Kellie Menter is 1639054448. It was assigned to this individual provider in the NPPES registry on August 11, 2025.

Q: What is Kellie Menter's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Kellie Menter was last updated on September 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.

Active since August 11, 2025PECOS Enrolled

1239 WINDHAM PKWY, ROMEOVILLE, IL 60446(815) 942-6323(815) 941-0308 Get Directions Write a Review

NPPES record last updated: September 5, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 5, 2025, Aug 11, 2025 (2 updates tracked since 2025).

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About Kellie Menter Phd, Lcp, Ncsp NPPES

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

KELLIE MENTER PHD, LCP, NCSP (NPI 1639054448) is an individual clinical neuropsychologist in Romeoville, Illinois, licensed in Illinois (071-022304) and active in the NPI registry since August 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1639054448

Entity TypeIndividualFemale

Primary Taxonomy103G00000X

Provider Legal NameKELLIE MENTERCredential: PHD, LCP, NCSP

Location Address1239 WINDHAM PKWYRomeoville, IL 60446-1608

Mailing AddressPo Box 713260Chicago, IL 60677-1260 · (630) 469-9200

Phone(815) 942-6323

Fax(815) 941-0308

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 11, 2025

Last NPPES UpdateSeptember 5, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 5, 2025

✔ NPI 1639054448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in IL · 071-022304

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

1239 WINDHAM PKWY, Romeoville, IL 60446

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kellie Menter Phd, Lcp, Ncsp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3577069525

PECOS Enrollment IDI20250930001734

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

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

WIMOL ANN MITRAKUL MD

Family Medicine