Individual provider Active NPI

Jeffrey Lewis

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1346721222
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.011769 Issued in IL
Practice address
20 N Clark St
Chicago, IL 60602-4109
Phone
(800) 866-7556
NPI assigned
Aug 28, 2018
Last updated
Jul 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.011769 IL Primary
Professional Counselor 101YP2500X 180011769 IL

Addresses

Primary practice location

20 N Clark St
Chicago, IL 60602-4109

Mailing address

20 N Clark St
Chicago, IL 60602-4109
Phone (800) 866-7556

Other practice location 1

4740 N Clark St
Chicago, IL 60640-4689
Phone (872) 235-0062

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
I20241010000922 IL Practitioner - Mental Health Counselor 5395277727 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.011769ILMDProfessional Counselor
180011769ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Professional CurrentSince Aug 27, 2024 Accepting new patients
Achieve Counseling PLLC Current Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

Organizations & group practices 2

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": "1535414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1346721222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024109",
            "telephone_number": "800-866-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024109",
            "telephone_number": "800-866-7556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4740 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606404689",
            "country_code": "US",
            "telephone_number": "872-235-0062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEFFREY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-28",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011769",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011769",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.