BELLEVILLE AREA SPECIAL SERVICES COOPERATIVE
NPI 1679090997
Psychologist - School in Belleville, IL
NPI Status: Active since August 28, 2017
Contact Information
2411 PATHWAYS XING
BELLEVILLE, IL
ZIP 62221
Phone: (618) 355-4700
- Organization
- Psychologist
- School
- CLIA Number: 14D2237127
- CLIA Cert. Type: School/Student Health Service
- CLIA Exp. Date: 09-21-2027
About BELLEVILLE AREA SPECIAL SERVICES COOPERATIVE
This page provides the complete NPI Profile along with additional information for Belleville Area Special Services Cooperative, a provider established in Belleville, Illinois operating as a Psychologist, focusing in school . The healthcare provider is registered in the NPI registry with number 1679090997 assigned on August 2017. The practitioner's primary taxonomy code is 103TS0200X with license number 394137 (IL). The provider is registered as an organization and their NPI record was last updated 4 years ago. Belleville Area Special Services Cooperative operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Jeff Daugherty (Executive Director)
- NPI
- 1679090997
- Provider Name
- BELLEVILLE AREA SPECIAL SERVICES COOPERATIVE
- Entity Type
- Organization
- Location Address
- 2411 PATHWAYS XING BELLEVILLE, IL 62221
- Location Phone
- (618) 355-4700
- Mailing Address
- 2411 PATHWAYS XING BELLEVILLE, IL 62221
- Mailing Phone
- (618) 355-4700
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-28-2017
- Last Update Date
- 07-21-2022
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist School
- Taxonomy Code
- 103TS0200X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 394137
- License State
- IL
- Taxonomy Description
- A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide a range of psychological diagnosis, assessment, intervention, prevention, health promotion, and program development and evaluation services with a special focus on the developmental processes of children and youth within the context of schools, families and other systems. School psychologists are prepared to intervene at the individual and system level, and develop, implement, and evaluate preventive programs. In these efforts, they conduct ecologically valid assessments and intervene to promote positive learning environments within which children and youth from diverse backgrounds to ensure that all have equal access to effective educational and psychological services that promote healthy development
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D2237127
- Facility Type
- School/Student Health Service
- Certificate Effective Date
- September 22, 2025
- Certificate Expiration Date
- September 21, 2027
- Laboratory Director
- JEFFREY R. DAUGHERTY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Belleville Area Special Services Cooperative to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1679090997, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BELLEVILLE, IL 62221
BELLEVILLE, IL 62221
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1679090997, enumerated as an "organization" on August 28, 2017.
The provider is located at 2411 PATHWAYS XING BELLEVILLE, IL 62221 and the phone number is (618) 355-4700.
Psychologist with taxonomy code 103TS0200X and a focus in School.
