Lindsay Brock Coulter, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

178012728 Issued in IL

Practice address

429 N Frolic Ave
Waukegan, IL 60085-6008

Phone

(773) 610-0864

NPI assigned

Apr 4, 2017

Last updated

Aug 25, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Edgewood Clinical Services, P.C.

  dba LifeStance

  • Psychologist
  • Naperville, IL
  • NPI 1295914646

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1992238208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 N FROLIC AVENUE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600853121",
            "telephone_number": "773-610-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 N FROLIC AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856008",
            "telephone_number": "773-610-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "LINDSAY",
        "middle_name": "BROCK",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178012728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Corea
• Abigail Corona
• Ruth Irene Costello, M.S.
• Allison Cotshott, RN
• Jamie Coultas
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)
• County of Lake (Lake County Health Department and Community Health Center)

• Mental Health Counselor in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.