Edessa Mirzapolos, Psy.D. PLLC
NPI 1740964204ActiveOrganization· Psychologist, Clinical· Plainfield, IL
Psychologist, Clinical in Plainfield, Illinois, registered in NPPES in June 2023. The authorized official on file is Edessa Mirzapolos, PSYD, Licensed Clinical Psychologist.
Overview
| NPI | 1740964204 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 14, 2023 |
| Last updated in NPPES | Jun 14, 2023 |
| Certified by provider | Jun 13, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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