Individual provider Active NPI

Lyna Teresa Tome

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1366006074
Registry record updated Apr 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178.014422 Issued in IL
Practice address
155 N Michigan Ave
Chicago, IL 60601-7511
Phone
(312) 278-3054
NPI assigned
Apr 29, 2019
Last updated
Apr 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.014422 IL Primary

Addresses

Primary practice location

155 N Michigan Ave
Chicago, IL 60601-7511

Mailing address

155 N Michigan Ave Ste 202
Chicago, IL 60601-7940

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
I20260406001122 IL Practitioner - Mental Health Counselor 7810462181 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindwell IncGroup PAC ID 4587949383, 7 clinicians

Practice addresses (Care Compare)

915 Harger Rd
Suite 101
Oak Brook, IL 60523-1400
Phone (708) 328-3225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178.014422ILMDProfessional Counselor

Organizations & group practices 1

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": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556496000000",
    "number": "1366006074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE STE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 N MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017511",
            "telephone_number": "312-278-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOME",
        "first_name": "LYNA",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.014422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.