Individual provider Active NPI

Kristine Lee Bartyzel, LPCC

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1366691263
Registry record updated Nov 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.009331 Issued in IL
Practice address
401 S. Lasalle St.
Ste 800J
Chicago, IL 60605-1057
Phone
(505) 920-5669
NPI assigned
Sep 16, 2008
Last updated
Nov 25, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 0135731 NM
Professional Counselor 101YP2500X 180.009331 IL Primary

Addresses

Primary practice location

401 S. Lasalle St.
Ste 800J
Chicago, IL 60605-1057

Mailing address

5005 N Meade Ave
Chicago, IL 60630-1824
Phone (505) 920-5669

Other identifiers 1

IdentifierTypeStateIssuer
88751031MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0135731NMMDMental Health Counselor
180.009331ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416873600000",
    "number": "1366691263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 N MEADE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606301824",
            "telephone_number": "505-920-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S. LASALLE ST.",
            "address_2": "STE 800J",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051057",
            "telephone_number": "505-920-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTYZEL",
        "first_name": "KRISTINE",
        "middle_name": "LEE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-16",
        "last_updated": "2014-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "0135731",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.009331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88751031",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.