Organization Active NPI

Lunare Wellness LLC

  • Clinical Social Worker
  • Evanston, IL
National Provider Identifier
1083060537
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.016297 Issued in IL
Legal business name
LUNARE WELLNESS LLC
Practice address
725 Washington St
Evanston, IL 60202-2283
Phone
(720) 273-6461
NPI assigned
May 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Lauren Lynn Zerbst, LCSWNPI 1225328065
Title
Owner
Phone
(773) 797-2238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 149.016297 IL Primary

Addresses

Primary practice location

725 Washington St
Evanston, IL 60202-2283

Mailing address

1428 W Jarvis Ave
Chicago, IL 60626
Phone (720) 273-6461

Other names 1

  • Lunare Wellness Services Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200515000122 IL Part B Supplier - Clinic/Group Practice 5193156792 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1083060537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 W JARVIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60626",
            "telephone_number": "720-273-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WASHINGTON ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022283",
            "telephone_number": "720-273-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUNARE WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-13",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "ZERBST",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-797-2238",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.016297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lunare Wellness Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.