Individual provider Active NPI

Gayle Robin Lane, LCPC

  • Professional Counselor
  • Lombard, IL
National Provider Identifier
1912632969
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.016719 Issued in IL
Practice address
15 S Lodge LN
Lombard, IL 60148-2916
Phone
(815) 412-5765
NPI assigned
Jul 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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 180.016719 IL Primary

Addresses

Primary practice location

15 S Lodge LN
Lombard, IL 60148-2916

Mailing address

15 S Lodge LN
Lombard, IL 60148-2916
Phone (815) 412-5765

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
I20260518000726 IL Practitioner - Mental Health Counselor 8729557913 Practice locations: Lombard, IL

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 S Lodge LN
Lombard, IL 60148-2916
Phone (815) 412-5765

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.016719ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bridgeview Clinical Services, LTD CurrentSince Feb 1, 2025 Accepting new patients
Mindful Journeys Therapy and Wellness CurrentSince Jun 29, 2025 Accepting new patients
Bridgeview Clinical Services, LTD CurrentSince Feb 1, 2025 Accepting new patients

Locations

1801 N Mill St
Ste M
Naperville, IL 60563
Phone (630) 536-8073

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1912632969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 S LODGE LN",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482916",
            "telephone_number": "815-412-5765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S LODGE LN",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601482916",
            "telephone_number": "815-412-5765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "GAYLE",
        "middle_name": "ROBIN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.016719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.