Individual provider Active NPI

Lonny Levin

  • Mental Health Counselor
  • Evanston, IL
National Provider Identifier
1346963386
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.016367 Issued in IL
Practice address
1007 Church St Ste 312
Evanston, IL 60201-5912
Phone
(888) 428-7890
NPI assigned
Sep 23, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178.017491 IL
Professional Counselor 101YP2500X 180.016367 IL
Mental Health Counselor 101YM0800X 180.016367 IL Primary

Addresses

Primary practice location

1007 Church St Ste 312
Evanston, IL 60201-5912

Mailing address

9106 Ewing Ave
Evanston, IL 60203-1708
Phone (847) 852-6896

Other practice location 1

9106 Ewing Ave
Evanston, IL 60203-1708
Phone (847) 852-6896

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
I20241217000142 IL Practitioner - Mental Health Counselor 3274060165 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.017491ILMDMental Health Counselor
180.016367ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Mental Health CurrentSince Nov 1, 2024 Accepting new patients
Psychology Specialists LTD Past Accepting new patients

Locations

808 S Eldorado Rd
Ste 102
Bloomington, IL 61704
Phone (309) 212-6007

1007 Church St
Ste 312
Evanston, IL 60201
Phone (844) 215-4468

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1346963386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9106 EWING AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602031708",
            "telephone_number": "847-852-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 CHURCH ST STE 312",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015912",
            "telephone_number": "888-428-7890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9106 Ewing Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602031708",
            "country_code": "US",
            "telephone_number": "847-852-6896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "LONNY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-23",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178.017491",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.016367",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.016367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.