Lake Behavioral Health Associates, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

LAKE BEHAVIORAL HEALTH ASSOCIATES, LLC

Practice address

7627 Lake St Ste 213
River Forest, IL 60305-1878

Phone

(773) 272-1939

NPI assigned

Mar 17, 2021

Last updated

Apr 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melissa S. Rowland, PSY.D.NPI 1942540869

Title

Clinical Psychologist

Phone

(773) 272-1939

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melissa S Rowland, PSYD

  • Clinical Psychologist
  • Joliet, IL
  • NPI 1942540869
  Medicare reassignment NPD Authorized official
• Jamie Heemin An, BA MS

  • Marriage & Family Therapist
  • River Forest, IL
  • NPI 1639057953
  NPD (past)
• Xitlali Campa

  • Professional Counselor
  • River Forest, IL
  • NPI 1043007602
  NPD (past)
• Heather Lea Corwin, PHD, LPC, RME, MFA

  • Mental Health Counselor
  • Oak Park, IL
  • NPI 1457982332
  NPD (past)
• Katherine M Johnson, LCSW

  • Clinical Social Worker
  • Addison, IL
  • NPI 1750939476
  NPD (past)
• Jason Kougan, LSW

  • Social Worker
  • River Forest, IL
  • NPI 1104747187
  NPD (past)
• Kate Odom

  • Clinical Psychologist
  • Oak Park, IL
  • NPI 1306079504
  NPD (past)
• Jasmine Brie Timmester, MA

  • Student in an Organized Health Care Education/Training Program
  • River Forest, IL
  • NPI 1912830993
  NPD (past)

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1467037754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0N071 MYRTLE ST",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601901027",
            "telephone_number": "773-272-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7627 LAKE ST STE 213",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051878",
            "telephone_number": "773-272-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE BEHAVIORAL HEALTH ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2022-04-12",
        "certification_date": "2021-05-14",
        "status": "A",
        "authorized_official_last_name": "ROWLAND",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "773-272-1939",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Kougan, LSW
• Mariya Koval, PHARMD
• Patricia M. Kowalik, D.D.S.
• Richard Francis Kraus, D.D.S.
• Sandesh Kuchipudi, M.D.
• Linda Sue Lambert, DPM
• Matthew Joseph Lambert III, M.D.
• Carrie Baltsen Landsman, PT
• Wendy R. Lauter, LCPC
• Ruta Lawrence, FNP

• Clinical Psychologist in River Forest, IL
• Providers in River Forest, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.