Laurin Jarrold Mack, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071009099 Issued in IL

Practice address

710 S Paulina St
Suite 316a
Chicago, IL 60612-3808

Phone

(312) 563-2781

NPI assigned

May 12, 2015

Last updated

Apr 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: lmack97883@direct.rush.rush-health.com

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649203200000",
    "number": "1780062638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 S PAULINA ST",
            "address_2": "SUITE 316A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123808",
            "telephone_number": "312-563-2781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S PAULINA ST",
            "address_2": "SUITE 316A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123808",
            "telephone_number": "312-563-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "LAURIN",
        "middle_name": "JARROLD",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-12",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071009099",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071009099",
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Mack, LSW
• Jasmine Ginger Mack
• Kaela Mack
• Ksenia Mack, PT, DPT
• Lara Mack, PA-C
• Mallory Mack
• Shale Mack, MD
• Derrick Anthony Mackavich, D.O.
• Micheal Patrick Macken, MD
• Ashlee Mackens

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.