Organization · Type 2 NPI

Pcpa Legacy, LLC

Clinical Psychologist · Northbrook, IL

NPI number 1093030132 Active

Practice location

400 Skokie Blvd Ste 245
Northbrook, IL 60062-7932

Fax (847) 446-4673

Specialties and licenses

Taxonomy	Code	License
Clinical Psychologist Primary	103TC0700X	071-004395 (IL)
Clinical Child & Adolescent Psychologist	103TC2200X	071-004395 (IL)

Clinical Psychologist: 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 discip…

2 other providers at this address

Other clinical psychologist providers in Northbrook

See all in Northbrook →

NPI record

NPI: 1093030132
Entity type: Organization (Type 2)
Issued: Apr 1, 2010
Last updated: Sep 6, 2023
Status: Active

Other names

<unavail>
Pcpa Legacy. LLC · doing business as
Primary Care Psychology Assocaites, LLC · former legal business name

Authorized official

Dr. Paul C Kredow, PSYD
Provider/owner
(847) 630-1611

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1093030132

Pcpa Legacy, LLC's National Provider Identifier is 1093030132, issued on Apr 1, 2010. The primary taxonomy on file is Clinical Psychologist (103TC0700X), and the practice location is in Northbrook, IL. The record was last updated on Sep 6, 2023.