Blaire Paulsen

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1010 Lake St Ste 500
Oak Park, IL 60301-1135

Phone

(773) 665-8052

Fax

(708) 384-7501

NPI assigned

Jun 16, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smart Love Parenting CenterGroup PAC ID 8729261011, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smart Love Parenting Center

  • Community/Behavioral Health Agency
  • Oak Park, IL
  • NPI 1922206101
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1023686987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 N DAYTON ST APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606147098",
            "telephone_number": "502-415-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LAKE ST STE 500",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011135",
            "telephone_number": "773-665-8052",
            "fax_number": "708-384-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULSEN",
        "first_name": "BLAIRE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathway Provider Services PC
• Farris Patterson III, DC
• Paul C. Ellstein Chiropractic Physicians, S.C.
• Paul Lazari LLC
• Zori A Paul, PHD, LPC, NCC
• Dina Pavilonis, M.D.
• Marcia M Pavlou, PHD
• Brandon Pavon
• Paxxon Healthcare Services LLC
• PCC Community Wellness Center

• Mental Health Counselor in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.