THE BRAIN CLINIC, LLC (NPI# 1972117521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972117521 |
| Entity Type | Organization |
| Organization Name | THE BRAIN CLINIC, LLC |
| Practice Address |
417 N Main St Sandwich IL 60548-1569 |
| Practice Telephone | 6306492819 |
| Mailing Telephone | 6306492819 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | DR. BRANDI KRISTEN BOAN (OWNER) |
| Authorized Official Telephone | 6306492819 |
| Authorized Official Credential | PSYD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | Behavioral Health & Social Service Providers | ||
| N | 103TP0016X |
Psychologist Specialization: Prescribing (Medical) |
Behavioral Health & Social Service Providers | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
417 N MAIN ST |
| City | SANDWICH |
| State | IL |
| Zip Code | 60548-1569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780862219 | Brandi Kristen Boan | Counselor | 417 N Main St, Sandwich, IL 60548-1569 | 2008-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366954166 | Northern Rehabilitation and Sports Medicine Associates | Physical Therapist | 523 E. Railroad Street, Suite A, Sandwich, IL 60548 | 2017-11-02 |
| 1538683040 | Ariel Eads | Counselor | 207 E Church St Unit A, Sandwich, IL 60548 | 2017-07-27 |
| 1093169138 | Kimberly S Miner | Acupuncturist | 100 South Latham Street, Suite 103b, Sandwich, IL 60548 | 2016-04-14 |
| 1316304058 | Dekalb Behavioral Health Foundation, Inc. | Clinic/Center | 100 S Latham St Ste 204, Sandwich, IL 60548 | 2016-01-26 |
| 1215006200 | Robert C Lerohl | Dentist | 430 S. Dayton Street, Sandwich, IL 60548 | 2006-11-06 |
| 1609950641 | Joseph Jimenez | Chiropractor | 823 E Church St, Sandwich, IL 60548 | 2006-10-25 |
| 1104919703 | Pharmacy Operations, Inc | Pharmacy | 142 Indian Springs Drive, Sandwich, IL 60548 | 2006-10-02 |
| 1902911076 | Jason Lee Robinson | Physical Therapist | 710 E Railroad St, Sandwich, IL 60548 | 2006-08-20 |
| 1982719209 | Anchor Dental Center Ltd | Dentist | 100 S Latham St, Sandwich, IL 60548 | 2006-08-19 |
| 1376566745 | Sandwich Community Fire Protection District | Ambulance | 310 E Railroad St, Sandwich, IL 60548 | 2006-07-25 |
| Find all providers in zip 60548 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063622694 | Kyriaki Antonia Fitzgerald | Psychologist | 90 Rte 6a, Suite 4c, Sandwich, MA 02563 | 2007-05-23 |
| 1225252620 | Cape Cod Neuropsychology, LLC | Psychologist | 68 Tupper Rd # 8, Sandwich, MA 02563-1872 | 2007-04-13 |
| 1205865797 | David M Callahan | Psychologist | 449 Route 130, Suite 12, Sandwich, MA 02563 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275265 | Susan Benjamin Feingold Psyd and Associates LLC | Psychologist | 1038 N Crosby St, Chicago, IL 60610-2404 | 2020-11-02 |
| 1326648247 | Ashley Head | Psychologist | 1161 S Walnut Ave, Arlington Heights, IL 60005-3053 | 2020-10-29 |
| 1932709052 | Mitchell B. Hoberman, Psy.d., P.C. | Psychologist | 8952 Samoset Trl, Skokie, IL 60076-1914 | 2020-10-28 |
| 1013524818 | Lincoln Park Psychology, Inc. | Psychologist | 644 W Webster Ave # B, Chicago, IL 60614-3710 | 2020-09-25 |
| 1962016386 | Brittney Aubin | Psychologist | 2555 N Clark St Apt 201, Chicago, IL 60614-1722 | 2020-09-02 |
| 1548873771 | Michael Wierman | Psychologist | 545 Newport Ct, Island Lake, IL 60042-9137 | 2020-08-27 |
| 1295348506 | Amaoli LLC | Psychologist | 164 Division St Ste 617, Elgin, IL 60120-5533 | 2020-08-26 |
| 1770192130 | Justin Davis Goldman | Psychologist | 15 Spinning Wheel Rd Ste 406, Hinsdale, IL 60521-5400 | 2020-07-30 |
| 1790393650 | Jerry Mark Otoole | Psychologist | 5700 Caton Farm Rd, Plainfield, IL 60586-9905 | 2020-07-16 |
| 1376165910 | Ji Yun Kang | Psychologist | 610 E John St Rm 236, Champaign, IL 61820-5717 | 2020-05-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.