Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLYN JACKSON, LPC, R-DMT
Active Sole ProprietorProfessional Counselor · CHICAGO, IL
Registration Details
- NPI Number
- 1073138194
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 15, 2020 (5.85252903701 yrs)
- Last Updated
- Oct 4, 2022
- Licenses
-
R-DMT-2538 (IL)178016509 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2835 N SHEFFIELD AVE STE 304CHICAGO, IL, 606575084Browse IL providers · Browse ZIP 60657
- Phone
- 6308665666
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Professional Counselor
Other Professional Counselor Providers in CHICAGO, IL
| Name | Credential | NPI |
|---|---|---|
| MS. DEBORAH FRY | L.C.P.C. | 1154313294 |
| BEATRIZ ELISABET LEDESMA | ATR LCPC | 1699762872 |
| MR. RAYMOND COLEY | LCPC | 1093796575 |
| AMY LYN ZAJAKOWSKI UHLL | LCPC | 1053394437 |
| MS. KATHLEEN M GRUBER | MA | 1326021718 |
| JOHN D MOORE | LCPC | 1013993328 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.