Virginia Lynn Lazarus, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007124 Issued in IL

Practice address

2530 Crawford Ave
Suite 212
Evanston, IL 60201-4970

Phone

(847) 604-1945

Fax

(847) 733-1217

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 14, 2019 through Jul 14, 2027

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Crawford Avenue Group Inc

  • Clinical Psychologist
  • Evanston, IL
  • NPI 1013409366
  NPD (past)

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619019080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 HARTZELL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011123",
            "telephone_number": "847-791-1624",
            "fax_number": "847-733-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 CRAWFORD AVE",
            "address_2": "SUITE 212",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602014970",
            "telephone_number": "847-604-1945",
            "fax_number": "847-733-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZARUS",
        "first_name": "VIRGINIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Lavere, OTR/L, CHT
• Christine B Lawlor, APN-CNP
• Peter Jermaine Lawrence Jr.
• Bradley Lazar
• Martin Lewis Lazarus, MD
• LBG Studio PLLC
• LDDP,LLC
• Lien Le, D.D.S
• Nghia Le
• Leah Nuetzel Happ, LCSW, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.