Individual provider Active NPI

Lise Ellen Schiffer, LCSW

  • Mental Health Counselor
  • Chicago, IL
National Provider Identifier
1669545919
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
149.003059 Issued in IL
Practice address
6900 N Campbell Ave
Chicago, IL 60645-4604
Phone
(772) 508-5301
Fax
(773) 508-9010
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149.003059 IL Primary

Addresses

Primary practice location

6900 N Campbell Ave
Chicago, IL 60645-4604

Mailing address

6900 N Campbell Ave
Chicago, IL 60645-4604
Phone (772) 508-5301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070427000460 IL Practitioner - Clinical Social Worker 1557467180 Practice locations: Chicago, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6900 N Campbell Ave
Chicago, IL 60645-4604
Phone (773) 508-5301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.003059ILMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669545919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6900 N CAMPBELL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454604",
            "telephone_number": "772-508-5301",
            "fax_number": "773-508-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6900 N CAMPBELL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606454604",
            "telephone_number": "772-508-5301",
            "fax_number": "773-508-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIFFER",
        "first_name": "LISE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149.003059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.