Organization Active NPI

Lantern Therapy Services, LTD

  • Mental Health Counselor
  • Crystal Lake, IL
National Provider Identifier
1619377637
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.007379 Issued in IL
Legal business name
LANTERN THERAPY SERVICES, LTD
Practice address
451 Coventry LN Ste 101
Crystal Lake, IL 60014-7569
Phone
(815) 503-9018
Fax
(779) 423-0778
NPI assigned
Aug 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Crisy Marie Gowan, LCPCNPI 1831420603
Title
President
Phone
(815) 503-9018

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 180.007379 IL Primary

Addresses

Primary practice location

451 Coventry LN Ste 101
Crystal Lake, IL 60014-7569

Mailing address

451 Coventry LN Ste 101
Crystal Lake, IL 60014-7569
Phone (815) 564-8633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171108001274 IL Part B Supplier - Clinic/Group Practice 3072879006 Receives reassigned benefits from 4 practitioners
Practice locations: Crystal Lake, IL

National Provider Directory

National Provider Directory

Locations

451 Coventry Ln
Ste 101
Crystal Lake, IL 60014
Phone (815) 404-8737

457 Coventry Ln
Ste 129A
Crystal Lake, IL 60014
Phone (815) 575-6224

451 Coventry Ln
Ste 100
Crystal Lake, IL 60014

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1619377637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 COVENTRY LN STE 101",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147569",
            "telephone_number": "815-564-8633",
            "fax_number": "779-423-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 COVENTRY LN STE 101",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147569",
            "telephone_number": "815-503-9018",
            "fax_number": "779-423-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANTERN THERAPY SERVICES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "GOWAN",
        "authorized_official_first_name": "CRISY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-503-9018",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.007379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.