Individual provider Active NPI

Georgette Elaine Lepage, MS, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1053490235
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180000239 Issued in IL
Practice address
3660 N Lake Shore Drive, Unit 3010
Chicago, IL 60613-5314
Phone
(708) 373-1952
Fax
(847) 675-7167
NPI assigned
Nov 6, 2006
Last updated
Dec 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180000239 IL Primary

Addresses

Primary practice location

3660 N Lake Shore Drive, Unit 3010
Chicago, IL 60613-5314

Mailing address

3660 N Lake Shore Drive, Unit 3010
Chicago, IL 60613-5314
Phone (708) 373-1952

Other identifiers 1

IdentifierTypeStateIssuer
01626639OtherILBLUE CROSS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250217001800 IL Practitioner - Mental Health Counselor 7719417005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1982
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3660 N Lake Shore Dr
Apt 3010
Chicago, IL 60613-5314
Phone (708) 373-1952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
180000239ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center for Emotional Growth Corp. Professional CurrentSince Nov 14, 2024 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1053490235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DRIVE, UNIT 3010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135314",
            "telephone_number": "708-373-1952",
            "fax_number": "847-675-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 N LAKE SHORE DRIVE, UNIT 3010",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606135314",
            "telephone_number": "708-373-1952",
            "fax_number": "847-675-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEPAGE",
        "first_name": "GEORGETTE",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "MS, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180000239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01626639",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.