Taylor Glen Shigeru Keoki Leisher

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178015953 Issued in IL

Practice address

30 N Michigan Ave Ste 1609
Chicago, IL 60602-3652

Phone

(773) 683-3555

NPI assigned

Oct 25, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Taylor Leisher Psychotherapy, PLLC

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1912681693
  NPD Authorized official

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1184267759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 N MARSHFIELD AVE APT 3F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225137",
            "telephone_number": "847-208-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE STE 1609",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023652",
            "telephone_number": "773-683-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISHER",
        "first_name": "TAYLOR",
        "middle_name": "GLEN SHIGERU KEOKI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-25",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178015953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ericka Lupe Leinard
• Anne Leinart Greene, APN
• Kirk R Leindecker, CRNA
• Elizabeth Seton Leinenweber, PA-S
• Mark Paul Leischner, M.D.
• Anne Bicket Leiter, MA. LCPC
• Candace Marie Leitheiser, LCSW
• Caitlyn Elizabeth Leiva, MS, RD
• Gloria Leiva, OTR
• Orly Leiva Jr., MD

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, 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 Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.