Individual provider Active NPI

Lara Garwood-Martin, LCPC

  • Professional Counselor
  • Schaumburg, IL
National Provider Identifier
1720550999
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
178011756 Issued in IL
Practice address
715 E Golf Rd Ste 200A1A
Schaumburg, IL 60173-4597
Phone
(847) 737-9191
NPI assigned
Dec 27, 2018
Last updated
Jan 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 178011756 IL
Professional Counselor 101YP2500X 178011756 IL Primary

Addresses

Primary practice location

715 E Golf Rd Ste 200A1A
Schaumburg, IL 60173-4597

Mailing address

715 E Golf Rd Ste 200A1A
Schaumburg, IL 60173-4597
Phone (847) 737-9191

Other identifiers 1

IdentifierTypeStateIssuer
178011756OtherILILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION

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
I20240212000846 IL Practitioner - Mental Health Counselor 0941643548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

715 E Golf Rd
Suite 200A1
Schaumburg, IL 60173-4595
Phone (847) 514-0432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
178011756ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edit Your Life Inc Professional CurrentSince Jan 1, 2024 Accepting new patients

Locations

715 E Golf Rd
Ste 200A1
Schaumburg, IL 60173
Phone (708) 807-0184

715 E Golf Rd
Ste 200A1A
Schaumburg, IL 60173
Phone (847) 514-0432

Organizations & group practices 1

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": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1720550999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 E GOLF RD STE 200A1A",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734597",
            "telephone_number": "847-737-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 E GOLF RD STE 200A1A",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734597",
            "telephone_number": "847-737-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARWOOD-MARTIN",
        "first_name": "LARA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178011756",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178011756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS DEPARTMENT OF PROFESSIONAL REGULATION",
            "identifier": "178011756",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.