DR. K. LARA BEANBLOSSOM PSYD - NPI 1427184795 - Psychologist in Winnetka, IL

Q: What is K. Lara Beanblossom's NPI number?

The NPI number for K. Lara Beanblossom is 1427184795. It was assigned to this individual provider in the NPPES registry on February 23, 2007. The provider is also known as Dr. Katharine Lara Beanblossom.

Q: What is K. Lara Beanblossom's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

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About Dr. K. Lara Beanblossom Psyd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. K. LARA BEANBLOSSOM PSYD (NPI 1427184795) is an individual clinical provider in Winnetka, Illinois, licensed in Illinois (071006369) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS, maintains a secondary practice location in Chicago, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1427184795

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameDR. K. LARA BEANBLOSSOMCredential: PSYD

Location Address545 LINCOLN AVE STE 4Winnetka, IL 60093-2349

Mailing Address30 N Michigan Ave, Ste 901Chicago, IL 60602-3767 · (312) 385-9777

Phone(312) 385-9777

Sole ProprietorYes

Medical School CMSOtherGraduated 2000

Enumeration DateFebruary 23, 2007

Last NPPES UpdateNovember 9, 20202 updates tracked since enumeration

NPPES CertifiedNovember 9, 2020

✔ NPI 1427184795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in IL · 071006369

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

545 LINCOLN AVE STE 4, Winnetka, IL 60093

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Other Names 1

Other Name (5)Dr. Katharine Lara Beanblossom

Secondary Practice Location 1

Location 130 N MICHIGAN AVE, STE 901CHICAGO, IL 60602-3767 · Phone (312) 385-9777

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. K. Lara Beanblossom Psyd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6204884018

PECOS Enrollment IDI20050108000101

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60093 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$183.39 typical visit price

range $60.08 – $183.39

Typical copayment $45.84 (range $15.02 – $45.84)

Most-billed visit code 99205

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRACE R SUN

Occupational Therapist