Individual provider Active NPI

Kelly E Laban, LCPC

  • Professional Counselor
  • Lombard, IL
National Provider Identifier
1801523204
Registry record updated Aug 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180012761 Issued in IL
Practice address
500 Waters Edge Ste 100
Lombard, IL 60148-7002
Phone
(331) 425-8625
NPI assigned
Aug 4, 2022
Last updated
Aug 4, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180012761 IL Primary

Addresses

Primary practice location

500 Waters Edge Ste 100
Lombard, IL 60148-7002

Mailing address

9312 178TH St
Tinley Park, IL 60487-7634
Phone (708) 268-4566

Other names 1

  • Kelly E Cody Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
180012761ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dayrise Wellness Clinicians of Illinois PLLC PastSince Aug 7, 2022 Accepting new patients
Attunement Collective LLC PastSince Aug 7, 2022 Accepting new patients
Mosaic Counseling and Wellness LLC Professional Past 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": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1801523204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9312 178TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877634",
            "telephone_number": "708-268-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WATERS EDGE STE 100",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601487002",
            "telephone_number": "331-425-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABAN",
        "first_name": "KELLY",
        "middle_name": "E",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180012761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CODY",
            "middle_name": "E",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.