Individual provider Active NPI

Lauren Crisostomo, LCPC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1093280778
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180013902 Issued in IL
Practice address
1200 W 35TH St Ste 5B5220
Chicago, IL 60609-1305
Phone
(312) 548-9051
NPI assigned
Oct 9, 2018
Last updated
Oct 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.014.140 IL
Professional Counselor 101YP2500X 178014140 IL
Professional Counselor 101YP2500X 180013902 IL Primary

Addresses

Primary practice location

1200 W 35TH St Ste 5B5220
Chicago, IL 60609-1305

Mailing address

1200 W 35TH St Ste 5B5220
Chicago, IL 60609-1305
Phone (312) 548-9051

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
I20231220002658 IL Practitioner - Mental Health Counselor 2062862832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Josselyn Center NFPGroup PAC ID 0840289740, 86 clinicians

Practice addresses (Care Compare)

1135 Skokie Blvd
Northbrook, IL 60062-4118
Phone (847) 441-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.014.140ILMDProfessional Counselor
178014140ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Josselyn Center NFP Current Accepting new patients
The Josselyn Center CurrentSince Jan 1, 2024 Accepting new patients
The Josselyn Center NFP CurrentSince Jan 1, 2024 Accepting new patients
Leyden Family Service & Mental Health Center Past Accepting new patients
Restoration Center Chicago PastSince Oct 10, 2021 Accepting new patients
Leyden Family Service & Mental Health Center Past Accepting new patients
The Josselyn Center NFP Past Accepting new patients

Locations

1135 Skokie Blvd
Northbrook, IL 60062
Phone (224) 505-5665

405 Central Ave
Northfield, IL 60093
Phone (847) 441-5603

Organizations & group practices 7

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": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1093280778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W 35TH ST STE 5B5220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091305",
            "telephone_number": "312-548-9051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W 35TH ST STE 5B5220",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091305",
            "telephone_number": "312-548-9051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISOSTOMO",
        "first_name": "LAUREN",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.014.140",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178014140",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.