DR. EUGENE S. CARROCCIA PSY.D. NPI 1598886103

NPI Information

NPI: 1598886103
Provider Name: DR. EUGENE S. CARROCCIA, PSY.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
4700 W 95TH ST
SUITE LL5
OAK LAWN, IL
ZIP 60453
Phone: (800) 216-1110
Get Directions

DR. Eugene S. Carroccia, PSY.D. is a clinical psychologist in Oak Lawn, 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. DR. Eugene S. Carroccia, PSY.D. NPI is 1598886103. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4700 W 95TH ST
SUITE LL5
OAK LAWN, IL
ZIP 60453-533
Phone: (800) 216-1110
Fax: (708) 346-4868

The enumeration date for this NPI number is 4/2/2007 and was last updated on 5/12/2009.

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
1	103TB0200X	Psychologist	Cognitive & Behavioral	071-006067	ILLINOIS	No
2	103TC2200X	Psychologist	Clinical Child & Adolescent	071-006067	ILLINOIS	No
3	103TF0000X	Psychologist	Family	071-006067	ILLINOIS	No
4	103TA0700X	Psychologist	Adult Development & Aging	071-006067	ILLINOIS	No
5	103TC0700X	Psychologist	Clinical	071-006067	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Q08538	MEDICARE UPIN	ILLINOIS
2	K04142	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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