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Organization
NOVA LUNA BEHAVIOR HEALTH SERVICES LLC
Active
Organization
NOVA LUNA BEHAVIOR HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA CARRILLO-GUERRERO (OWNER)
(773) 615-5415
Entity
Organization
Contact information
Practice address
1653 W 35TH ST, CHICAGO, IL 60609-1309
(773) 615-5415
Mailing address
1653 W 35TH ST, CHICAGO, IL 60609-1309
(773) 615-5415
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/25/2024
Last updated
08/25/2025
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