MEMORIAL MEDICAL CENTER NPI 1104888981

NPI Information

  • NPI: 1104888981
  • Provider Name: MEMORIAL MEDICAL CENTER
  • Classification: Psychologist - 103TC0700X
  • Specialization: Clinical
  • Entity Type: Organization
  • Other Name: CLINICAL PSYCHOLOGISTS
  • Address: 701 N 1ST ST
    SPRINGFIELD, IL
    ZIP 62781
  • Phone: (217) 788-3000

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NPI Details

MEMORIAL MEDICAL CENTER is a clinical psychologist in Springfield, IL. The provider is 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. MEMORIAL MEDICAL CENTER NPI is 1104888981. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Clinical Psychologists.

The provider's business location address is:

701 N 1ST ST
SPRINGFIELD, IL
ZIP 62781-001
Phone: (217) 788-3000

The provider's authorized official is Jameson M Roszhart .
The authorized official title is President And Ceo and has the following contact phone number (217) 788-3000.

The enumeration date for this NPI number is 4/5/2006 and was last updated on 6/14/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TC0700XPsychologistClinicalYes

What is NPI?

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This page was last updated on: 3/30/2025

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