Individual provider Active NPI

Lauren Anne Marciszyn, RD, LPC

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1649419706
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
178018798 Issued in IL
Practice address
5537 N Clark St # B-1
Chicago, IL 60640-0751
Phone
(773) 302-1609
NPI assigned
Feb 12, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 2737 MA
Mental Health Counselor 101YM0800X 178018798 IL Primary

Addresses

Primary practice location

5537 N Clark St # B-1
Chicago, IL 60640-0751

Mailing address

1461 W Edgewater Ave Apt 3
Chicago, IL 60660-5683
Phone (774) 644-1012

Other practice location 1

1461 W Edgewater Ave Apt 3
Chicago, IL 60660-5683
Phone (774) 644-1012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
178018798ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1649419706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 W EDGEWATER AVE APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606605683",
            "telephone_number": "774-644-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5537 N CLARK ST # B-1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606400751",
            "telephone_number": "773-302-1609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1461 W Edgewater Ave Apt 3",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606605683",
            "country_code": "US",
            "telephone_number": "774-644-1012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCISZYN",
        "first_name": "LAUREN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "RD, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "MA",
            "license": "2737",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178018798",
            "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 Jan 11, 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.