Individual provider Active NPI

Jason Edward Lahood, PSY.D.

  • Clinical Psychologist
  • Chicago, IL
National Provider Identifier
1710289590
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071008046 Issued in IL
Practice address
3317 W Le Moyne St
Chicago, IL 60651-2452
Phone
(312) 659-0200
NPI assigned
Nov 29, 2010
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 071008046 IL Primary
Clinical Child & Adolescent Psychologist 103TC2200X 071008046 IL
Group Psychotherapy Psychologist 103TP2701X 071008046 IL

Addresses

Primary practice location

3317 W Le Moyne St
Chicago, IL 60651-2452

Mailing address

3317 W Le Moyne St
Chicago, IL 60651-2452
Phone (312) 659-0200

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL jlahood@psychbreak.com Direct

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
I20110225000734 IL Practitioner - Clinical Psychologist 8325229156 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071008046ILMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
M Pachan PHD PLLC Current Accepting new patients
Veritas Therapy Solutions LLC Clinical CurrentSince Jan 24, 2011 Accepting new patients

Organizations & group practices 3

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": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1710289590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3317 W LE MOYNE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512452",
            "telephone_number": "312-659-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3317 W LE MOYNE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606512452",
            "telephone_number": "312-659-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHOOD",
        "first_name": "JASON",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-29",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071008046",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "IL",
            "license": "071008046",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "IL",
            "license": "071008046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jlahood@psychbreak.com",
            "affiliation": "N",
            "endpointDescription": "business email MS 365 HIPPA COMPLIANT",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "8 S Michigan Ave Ste 2100",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606033337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.