Southpark Psychology Ltd
NPI 1558470419 · Counseling Psychologist · Moline, IL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Southpark Psychology Ltd is a Counseling Psychologist organization in Moline, IL (NPI 1558470419).
Provider details
- NPI number
- 1558470419
- Entity type
- Organization
- Primary specialty
- Counseling PsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Carl Vincent, Owner(309) 797-2900
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Psychologist103TC0700X
Behavioral Health & Social Service Providers
- Clinical Social Worker1041C0700X
Behavioral Health & Social Service Providers
- Professional Counselor101YP2500X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
- 2006-08-30
- Last updated
- 2018-01-26
Frequently asked questions
- What is Southpark Psychology Ltd's NPI number?
- Southpark Psychology Ltd's National Provider Identifier (NPI) is 1558470419, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Southpark Psychology Ltd?
- Southpark Psychology Ltd is classified in the NPPES registry as Counseling Psychologist (Behavioral Health & Social Service Providers).
- Where is Southpark Psychology Ltd located?
- Southpark Psychology Ltd's practice location on file with NPPES is 2100 52nd Ave, Moline, IL 61265-6366.
- What is Southpark Psychology Ltd's phone number?
- The practice phone number listed in the NPPES registry for Southpark Psychology Ltd is (309) 797-2900.
- Does Southpark Psychology Ltd accept Medicare?
- Southpark Psychology Ltd is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Southpark Psychology Ltd?
- The authorized official listed on Southpark Psychology Ltd's NPPES record is Carl Vincent, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Southpark Psychology Ltd's NPI active?
- Yes — Southpark Psychology Ltd's NPI (1558470419) is active in the NPPES registry as of the last update on 2018-01-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.