Dr. Sandra Ellen Johnson Clavelli
Clinical Psychologist
420 W. Grand Ave
Lake Villa
, Illinois 60046
Dr. Sandra Ellen Johnson Clavelli
Clinical Psychologist
420 W. Grand Ave
Lake Villa
, Illinois 60046
(847) 636-7637
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Sandra Ellen Johnson Clavelli
- 2699 Hobson Rd Apt 6
- Woodridge, IL
- Zip : 60517-1550
- Phone : (847) 636-7637
Second Address
- Dr. Sandra Ellen Johnson Clavelli
- 420 W. Grand Ave
- Lake Villa, IL
- Zip : 60046
- Phone : (847) 245-6469
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | 71007250 | IL |
| Y | 103TC0700X | Clinical Psychologist | 71007250 | IL |
National Provider Identifier
| NPI | 1003023714 |
|---|---|
| Provider Name | Dr. Sandra Ellen Johnson Clavelli |
| First Address | Woodridge, IL 60517-1550 |
| Second Address | Lake Villa, IL 60046 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/05/2007 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.