Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1407956758 Individual Practitioner Male Practitioner

Dr. Tim Shannon , PsyD

Psychologist • Normal, IL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Tim Shannon, PsyD is a certified Psychologist practicing in Normal, IL. With approximately 35 years of clinical experience since completing medical education in 1991, Dr. Shannon delivers high-quality medical care to the local community at 405 KAYS DR STE C.

Dr. Shannon is affiliated with Osf Multi-Specialty Group and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include psychotherapy, psychiatric diagnostic evaluation. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

405 Kays Dr Ste C

Normal, IL 617611979

Telephone 3096643130
Fax 3096643528
Associated Practice Facility / Clinic
🏢 Mental Wellness Center Inc Facility NPI 1629596812

Medicare Profile & Education

Medical School

Other

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Psychologist in Normal, IL

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
35 Yrs Matches City Avg
City Avg: 35.0 Yrs
State Avg: 25.1 Yrs
Regional Practice Density
1 Specialists

Practicing in Normal, IL (1075 Statewide)

Telehealth Adoption Rate
100.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
66.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Shannon (35 Years) 35 Yrs
Normal Specialty Average (35.0 Years) 35.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
90834 Psychotherapy, 45 minutes
123 32 $273.89 $92.91
90791 Psychiatric diagnostic evaluation
19 19 $478.00 $158.99

Medical Specialties & State Licenses

Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

State License IL 071004783

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Medicare Group Ptan
IL2613 (IL)
Commercial Insurance / Payer ID Rr Medicare Group
DP5951
Commercial Insurance / Payer ID Rr Medicare Individual
P00820811

Hospital & Practice Group Affiliations

Osf Multi-Specialty Group

1701 E College Ave, Bloomington, IL 617042101

Phone: 3096643130

Osf Multi-Specialty Group

8600 State Route 91, Peoria, IL 616157829

Phone: 3096835050

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Christopher Cashen , LCPC

Counselor - Professional

NPI 1013037621

Licensed Clinical Professional Counselor

Rachel Simon , LCPC

Counselor - Professional

NPI 1023237567

Licensed Clinical Professional Counselor

Cheri Carroll , LCSW

Social Worker - Clinical

NPI 1083747356

Licensed Clinical Social Worker

Jaycie Liebendorfer , APRN, CNP

Nurse Practitioner - Primary Care

NPI 1124329206

Advanced Practice Registered Nurse, Certified Nurse Practitioner

Dr. Robert Hamilton , MD

Psychiatry & Neurology - Psychiatry

NPI 1164431904

Doctor of Medicine (M.D.)

Jaime Duffy , APN

Nurse Practitioner - Psychiatric/Mental Health

NPI 1568281749

Advanced Practice Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 09, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location May 09, 2011

Registered at 405 KAYS DR STE C, NORMAL, IL 617611979 (Tel: 3096643130)

📍
Updated Business Mailing Address May 09, 2011

Registered at 405 KAYS DR STE C, NORMAL, IL 617611979 (Tel: 3096643130)

👤
Provider Name / Credentials Updated May 09, 2011

Recorded as TIM SHANNON, PSYD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 09, 2011

Psychologist (License #071004783 in IL)

🟢
Initial NPI Registration & Enumeration September 25, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407956758
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 25, 2006
Last Update: May 09, 2011
Sole Proprietor: No

Mailing Address

405 Kays Dr Ste C

Normal, IL 617611979

Phone: 3096643130

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.