Lisa Cook, DRPH, LCPC, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.016410 Issued in IL

Practice address

1112 W Boughton Rd # 146
Bolingbrook, IL 60440-1508

Phone

(312) 561-4292

NPI assigned

Sep 13, 2013

Last updated

Oct 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Life Impact Circles of Wellness

  • Mental Health Counselor
  • Bolingbrook, IL
  • NPI 1326861907
  NPD Authorized official

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1487089041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 W BOUGHTON RD # 146",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401508",
            "telephone_number": "312-561-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 W BOUGHTON RD # 146",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401508",
            "telephone_number": "312-561-4292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9509 Deerfoot Trce Apt 201",
            "address_purpose": "LOCATION",
            "city": "Prospect",
            "state": "KY",
            "postal_code": "400595108",
            "country_code": "US",
            "telephone_number": "847-250-0850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1616 E Roosevelt Rd",
            "address_2": "Suite 8",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601876850",
            "country_code": "US",
            "telephone_number": "630-588-1201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "DRPH, LCPC, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-13",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "265707",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.006892",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.016410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.