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Organization
K RENA GROUP
Active
Organization
K RENA GROUP
Active
Other names
Kenyon Douglass
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KENYON R DOUGLASS LCPC (OWNER/OPERATOR - CEO)
(312) 388-9182
Entity
Organization
Contact information
Practice address
2525 S WABASH AVE, CHICAGO, IL 60616-2308
(312) 388-9182
Mailing address
8850 S LONGWOOD DR, CHICAGO, IL 60643-5940
(312) 388-9182
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
Other
Enumeration date
12/31/2024
Last updated
12/31/2024
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