Jae Myung Lee, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178.013659 Issued in IL

Practice address

1166 S Elmhurst Rd
Mt Prospect, IL 60056-4241

Phone

(847) 439-5195

NPI assigned

Apr 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hanul Family Alliance

  • Adult Mental Health Clinic/Center
  • Mt Prospect, IL
  • NPI 1215821616
  NPD (past)
• Hanul Family Alliance

  • Clinical Social Worker
  • Lincolnshire, IL
  • NPI 1558851311

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1336637586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 S ELMHURST RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600564241",
            "telephone_number": "847-439-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 S ELMHURST RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600564241",
            "telephone_number": "847-439-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAE",
        "middle_name": "MYUNG",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "178.013659",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.013659",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "IL",
            "license": "178.013659",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.013659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Caccamo Wellness, PLLC
• Alison E Lechner, D.O
• Cha I Lee, D.C.
• Charles C Lee, DC
• Eunice Lee
• Ronald D Lee, M.D.
• Legacy
• Legacy Medical Care Inc
• Richard Dale Lenzen, OD
• Leonid Ayzenberg, M.D. Inc

• Mental Health Counselor in Mt Prospect, IL
• Providers in Mt Prospect, 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 Apr 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.