Southern Illinois University Carbondale Clinical Center
NPI 1174919351 · Psychologist · Carbondale, IL
Southern Illinois University Carbondale Clinical Center is a Psychologist organization in Carbondale, IL (NPI 1174919351).
Provider details
- NPI number
- 1174919351
- Entity type
- Organization
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Parent organization
- Southern Illinois University Carbondale
- Organization subpart
- Yes
- Authorized official
- Holly Cormier, Director(618) 453-2361
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Counseling Psychologist103TC1900X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2015-04-14
- Last updated
- 2015-04-14
Frequently asked questions
- What is Southern Illinois University Carbondale Clinical Center's NPI number?
- Southern Illinois University Carbondale Clinical Center's National Provider Identifier (NPI) is 1174919351, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southern Illinois University Carbondale Clinical Center?
- Southern Illinois University Carbondale Clinical Center is classified in the NPPES registry as Psychologist (Behavioral Health & Social Service Providers).
- Where is Southern Illinois University Carbondale Clinical Center located?
- Southern Illinois University Carbondale Clinical Center's practice location on file with NPPES is 625 Wham Drive Room 141, Carbondale, IL 62901.
- What is Southern Illinois University Carbondale Clinical Center's phone number?
- The practice phone number listed in the NPPES registry for Southern Illinois University Carbondale Clinical Center is (618) 453-2361.
- Who is the authorized official for Southern Illinois University Carbondale Clinical Center?
- The authorized official listed on Southern Illinois University Carbondale Clinical Center's NPPES record is Holly Cormier, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southern Illinois University Carbondale Clinical Center's NPI active?
- Yes — Southern Illinois University Carbondale Clinical Center's NPI (1174919351) is active in the NPPES registry as of the last update on 2015-04-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.