Individual provider Active NPI

Lynn Sewester Underwood, MA, LCPC

  • Professional Counselor
  • O Fallon, IL
National Provider Identifier
1700353679
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.011860 Issued in IL
Practice address
791 Wall St
O Fallon, IL 62269-2087
Phone
(618) 514-1154
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 180.011860 IL
Professional Counselor 101YP2500X 180.011860 IL Primary

Addresses

Primary practice location

791 Wall St
O Fallon, IL 62269-2087

Mailing address

791 Wall St
O Fallon, IL 62269-2087
Phone (618) 514-1154

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
I20251209000365 IL Practitioner - Mental Health Counselor 0648764605 Practice locations: O Fallon, IL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 N Fillmore St
Edwardsville, IL 62025-1219

791 Wall St
Suite 100
O Fallon, IL 62269-2087
Phone (618) 514-1154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
180.011860ILMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1700353679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "791 WALL ST",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692087",
            "telephone_number": "618-514-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 WALL ST",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692087",
            "telephone_number": "618-514-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "LYNN",
        "middle_name": "SEWESTER",
        "credential": "MA, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "180.011860",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

Verify at the official NPI Registry.