Individual provider · Type 1 NPI

Kellyn Jackson, LPC, R-DMT

Professional Counselor · Chicago, IL

NPI number 1073138194 Active

Practice location

2835 N Sheffield Ave Ste 304
Chicago, IL 60657-5084

Call (630) 866-5666 Map

Mailing address

7400 N Sheridan Rd Apt 3A
Chicago, IL 60626-2059

Other practice locations

  • 2310 W Roosevelt Rd, Chicago, IL 60608-1131 · (312) 439-1552

Specialties and licenses

TaxonomyCodeLicense
Dance Therapist 225600000XR-DMT-2538 (IL)
Professional Counselor Primary 101YP2500X178016509 (IL)

Professional Counselor: Definition to come...

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About NPI 1073138194

Kellyn Jackson, LPC, R-DMT's National Provider Identifier is 1073138194, issued on Jun 15, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Chicago, IL. The record was last updated on Oct 4, 2022.