Individual provider Active NPI

Gary Michelsen, LCPC

  • Mental Health Counselor
  • Arlington Heights, IL
National Provider Identifier
1700999240
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180002991 Issued in IL
Practice address
3436 N Kennicott Ave
Arlington Heights, IL 60004-7814
Phone
(847) 952-7460
Fax
(847) 222-1754
NPI assigned
Aug 17, 2006
Last updated
Jun 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180002991 IL
Mental Health Counselor 101YM0800X 180002991 IL Primary

Addresses

Primary practice location

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814

Mailing address

3436 N Kennicott Ave
Arlington Heights, IL 60004-7814
Phone (847) 952-7460

Other identifiers 1

IdentifierTypeStateIssuer
0081646697OtherILBCBS

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
I20240529000652 IL Practitioner - Mental Health Counselor 1951550383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

1500 Eisenhower LN
Unit E
Lisle, IL 60532-2125
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Specialists LTD Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.garymichelsen@146897.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1700999240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3436 N KENNICOTT AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600047814",
            "telephone_number": "847-952-7460",
            "fax_number": "847-222-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSEN",
        "first_name": "GARY",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180002991",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180002991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0081646697",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.