Elisa Julia Lee, LCPC, NBCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180013779 Issued in IL

Practice address

6815 W 63Rd St Ste 7
Chicago, IL 60638-4066

Phone

(708) 304-3010

Fax

(708) 575-5333

NPI assigned

May 19, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Mindful Behavior

  • Mental Health Counselor
  • Chicago, IL
  • NPI 1558035519
  NPD Authorized official
• Mindful Behavior LLC

  • Counseling Psychologist
  • Chicago, IL
  • NPI 1558065300
  NPD Authorized official
• Mindful Behavior LLC

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1780407189
  NPD Authorized official

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1215384292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388556",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606388556",
            "telephone_number": "708-304-3010",
            "fax_number": "708-575-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 W 63RD ST STE 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606384066",
            "telephone_number": "708-304-3010",
            "fax_number": "708-575-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3245 Grove Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023476",
            "country_code": "US",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 S Michigan Ave Ste 612",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606033488",
            "country_code": "US",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 N Oak Park Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011340",
            "country_code": "US",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ELISA",
        "middle_name": "JULIA",
        "credential": "LCPC, NBCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-19",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178013267",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "$$$$$$$$$",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elainelee@mindfulbehavior7.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "file",
            "address_1": "6815 W 63rd St Ste 7",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606384066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diamond Lee
• Diana Sara Rose Lee, NP
• Diane Lee, OD
• Edward Chung Lee, MD
• Elinor Lee, LCSW
• Erica Marie Lee, D.M.D.
• Ernest Lee, M.D
• Esther G. Lee, M.D.
• Eun Hye Lee
• Evelyn M Lee, DPT

• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.