Lake Michigan Psychotherapy Services, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LAKE MICHIGAN PSYCHOTHERAPY SERVICES, PLLC

Practice address

4050 N Lincoln Ave
Chicago, IL 60618-3067

Phone

(773) 257-3017

NPI assigned

Mar 16, 2026

Last updated

Mar 16, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Michelsen, LCPCNPI 1336878735

Title

Owner

Phone

(773) 257-3017

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan Michelsen

  • Professional Counselor
  • Chicago, IL
  • NPI 1336878735
  NPD Authorized official

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

{
    "created_epoch": "1773619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773619200000",
    "number": "1730036823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183067",
            "telephone_number": "773-257-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183067",
            "telephone_number": "773-257-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MICHIGAN PSYCHOTHERAPY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-16",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A",
        "authorized_official_last_name": "MICHELSEN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-257-3017",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.