Individual provider Active NPI

Amanda Lukas, LCPC

  • Mental Health Counselor
  • Park Ridge, IL
National Provider Identifier
1801451547
Registry record updated Jan 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
180.008571 Issued in IL
Practice address
250 S Northwest Hwy Ste 110
Park Ridge, IL 60068-4237
Phone
(224) 422-2149
NPI assigned
May 8, 2019
Last updated
Jan 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2025

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 180.008571 IL Primary
Professional Counselor 101YP2500X 180.008571 IL

Addresses

Primary practice location

250 S Northwest Hwy Ste 110
Park Ridge, IL 60068-4237

Mailing address

2541 N. Lincoln Ave
#206
Chicago, IL 60614
Phone (773) 469-6675

Other practice location 1

2451 N Lincoln Ave # 206
Chicago, IL 60614
Phone (224) 422-2149

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
I20240419002224 IL Practitioner - Mental Health Counselor 2668811894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edgewood Clinical Services P.C.Group PAC ID 3971963901, 304 clinicians

Practice addresses (Care Compare)

250 S Northwest Hwy
Suite 110
Park Ridge, IL 60068-4237
Phone (888) 428-7890

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.008571ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edgewood Clinical Services, P.C. Mental Health CurrentSince Mar 10, 2024 Accepting new patients
Psychology Specialists LTD Past Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

1616 N Damen Ave
Ste 301
Chicago, IL 60647
Phone (312) 761-4720

2948 Artesian Rd
Ste 112
Naperville, IL 60564
Phone (630) 328-0165

250 S Northwest Hwy
Ste 110
Park Ridge, IL 60068
Phone (224) 422-2149

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.amandaharris@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": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737763200000",
    "number": "1801451547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 N. LINCOLN AVE",
            "address_2": "#206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60614",
            "telephone_number": "773-469-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S NORTHWEST HWY STE 110",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684237",
            "telephone_number": "224-422-2149"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2451 N Lincoln Ave # 206",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60614",
            "country_code": "US",
            "telephone_number": "224-422-2149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUKAS",
        "first_name": "AMANDA",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2025-01-25",
        "certification_date": "2025-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.008571",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008571",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.