Lisa Medalie, PSYD, CBSM

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071.008089 Issued in IL

Practice address

1101 Davis St
Evanston, IL 60201-5945

Phone

(773) 702-6169

NPI assigned

Mar 15, 2011

Last updated

Mar 29, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, FL, WI3 enrollments

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 3

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Drlullaby, LLCGroup PAC ID 9931507290, shared by 7 NPIs, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Drlullaby LLC

  • Clinic/Center
  • Chicago, IL
  • NPI 1598433898
  Medicare reassignment NPD Authorized official
• Drlullaby LLC

  • Clinic/Center
  • Union Grove, WI
  • NPI 1003520149
  Medicare reassignment NPD Authorized official
• Drlullaby LLC

  • Clinic/Center
  • North Miami Beach, FL
  • NPI 1790499838
  Medicare reassignment NPD Authorized official
• The University of Chicago Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1033218128
  Medicare reassignment NPD
• Dr Lullaby LLC

  • Clinic/Center
  • Highland, IN
  • NPI 1679289615
  Authorized official Same address or phone
• Dr Lullaby LLC

  • Clinic/Center
  • Glendale, CO
  • NPI 1962118539
  NPD (past) Authorized official
• Drlullaby LLC

  • Clinic/Center
  • Burke, VA
  • NPI 1164138731
  NPD (past) Authorized official
• Drlullaby LLC

  • Psychologist
  • Newport Beach, CA
  • NPI 1174239636
  Authorized official Same address or phone
• Drlullaby LLC

  • Clinic/Center
  • Baltimore, MD
  • NPI 1568178689
  NPD (past) Authorized official
• Drlullaby LLC

  • Clinic/Center
  • Cincinnati, OH
  • NPI 1588378616
  NPD (past) Authorized official
• Drlullaby, LLC

  • Clinic/Center
  • McComb, MS
  • NPI 1063128635
  Authorized official Same address or phone
• Drlullaby, LLC

  • Clinic/Center
  • Frisco, TX
  • NPI 1598479636
  NPD (past) Authorized official

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1609175744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 DAVIS ST STE 5767",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015945",
            "telephone_number": "844-475-3379",
            "fax_number": "855-644-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 DAVIS ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602015945",
            "telephone_number": "773-702-6169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDALIE",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSYD, CBSM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2024-03-29",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.008089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret McPherson
• Colleen Elizabeth McShane, D.D.S.
• Thomas McSheehy, MSW, LSW
• MDR Therapy, PLLC
• Meals at Home
• Brian Medley, APN-CNP
• Gustavo Medrano, PHD
• Bridget Ann Meehan
• Inna Meerson
• Julia Mefferd, LMFT

• Clinical Neuropsychologist in Evanston, IL
• Providers in Evanston, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.