NPIMap

Organization Active NPI

Mindful Behavior LLC

  • Counseling Psychologist
  • Chicago, IL
National Provider Identifier
1558065300
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
MINDFUL BEHAVIOR LLC
Practice address
6815 W 63Rd St
Chicago, IL 60638-4048
Phone
(708) 304-3010
Fax
(708) 535-5333
NPI assigned
Mar 27, 2023
Last updated
May 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Elisa J Lee, LCPCNPI 1215384292
Title
Owner
Phone
(708) 304-3010

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

6815 W 63Rd St
Chicago, IL 60638-4048

Mailing address

PO Box 388556
Chicago, IL 60638-8556
Phone (708) 304-3010

Other practice location 1

3245 Grove Ave Ste 208
Berwyn, IL 60402-3476
Phone (708) 304-3010

Other practice location 2

8 S Michigan Ave Ste 612
Chicago, IL 60603-3488
Phone (708) 304-3010

Other practice location 3

137 N Oak Park Ave Ste 212
Oak Park, IL 60301-1340
Phone (708) 304-3010

National Provider Directory

National Provider Directory
Tax ID family
Mindful Behavior LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3245 Grove Ave
Ste 208
Berwyn, IL 60402
Phone (708) 795-0100

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1558065300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388556",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606388556",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606384048",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3245 Grove Ave Ste 208",
            "address_purpose": "LOCATION",
            "city": "Berwyn",
            "state": "IL",
            "postal_code": "604023476",
            "country_code": "US",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 S Michigan Ave Ste 612",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606033488",
            "country_code": "US",
            "telephone_number": "708-304-3010",
            "fax_number": "708-535-5333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "137 N Oak Park Ave Ste 212",
            "address_purpose": "LOCATION",
            "city": "Oak Park",
            "state": "IL",
            "postal_code": "603011340",
            "country_code": "US",
            "telephone_number": "708-304-3010",
            "fax_number": "708-304-3010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINDFUL BEHAVIOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ELISA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-304-3010",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 16, 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.