Individual provider Active NPI

Lauren Lustfeldt

  • Professional Counselor
  • Chicago, IL
National Provider Identifier
1861115768
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180014697 Issued in IL
Practice address
3665 N Broadway St
Chicago, IL 60613-4567
Phone
(773) 496-4433
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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 180014697 IL Primary

Addresses

Primary practice location

3665 N Broadway St
Chicago, IL 60613-4567

Mailing address

3840 N Wilton Ave Apt 1
Chicago, IL 60613-0138

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
180014697ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Clarity Clinic PLLC CurrentSince Oct 2, 2022 Accepting new patients

Locations

3665 N Broadway St
Chicago, IL 60613
Phone (773) 496-4433

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1861115768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 N WILTON AVE APT 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606130138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3665 N BROADWAY ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606134567",
            "telephone_number": "773-496-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTFELDT",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180014697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.