Kyle Lee Lisowski, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180.012016 Issued in IL

Practice address

1938 E Lincoln Hwy
New Lenox, IL 60451-3810

Phone

(708) 828-4636

NPI assigned

Oct 4, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sixty Forty Counseling PLLC

  • Professional Counselor
  • Naperville, IL
  • NPI 1134908676
  NPD Authorized official

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1982114922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11004 1ST ST",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604481506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1938 E LINCOLN HWY",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604513810",
            "telephone_number": "708-828-4636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13136 Western Ave",
            "address_purpose": "LOCATION",
            "city": "Blue Island",
            "state": "IL",
            "postal_code": "604062423",
            "country_code": "US",
            "telephone_number": "708-828-4636",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11004 1st St",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604481506",
            "country_code": "US",
            "telephone_number": "708-828-4636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISOWSKI",
        "first_name": "KYLE",
        "middle_name": "LEE",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.012900",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.012016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lincoln-Way Chiropractic Clinic LLC
• Lincoln-Way High School District 210
• Lincolnway Medical Associates, P.C.
• Lincolnway Surgical Assistants L.L.C.
• Sonja Linde, RN
• Listen Nook
• Little Dragons Pediatric Counseling PLLC
• Little Minds Pediatric Therapy LLC
• Matthew Edward Littlefield, LPC
• Cammie C Liu, MMS, PA-C

• Professional Counselor in New Lenox, IL
• Providers in New Lenox, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; 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.