Lisa Dvorak, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.016125 Issued in IL

Practice address

2101 Waukegan Rd
Bannockburn, IL 60015-1836

Phone

(847) 421-9200

NPI assigned

Aug 19, 2021

Last updated

Aug 19, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1225704158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 OLD MILL CIR",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693305",
            "telephone_number": "847-421-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WAUKEGAN RD",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151836",
            "telephone_number": "847-421-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DVORAK",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.016125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.faithlifecounseling.com",
            "affiliation": "N",
            "endpointDescription": "FLC general",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2101 Waukegan Rd Ste 302",
            "city": "Bannockburn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600151836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.faithlifecounseling.com",
            "affiliation": "N",
            "endpointDescription": "office",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2101 Waukegan Rd Ste 302",
            "city": "Bannockburn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600151836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "lisa@faithlifecounseling.com",
            "affiliation": "N",
            "endpointDescription": "FLC email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2101 Waukegan Rd Ste 302",
            "city": "Bannockburn",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600151836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Bannockburn, IL
• Providers in Bannockburn, 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 Aug 19, 2021; 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.