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Organization
REVAMPED RELATIONSHIPS
Active
Organization
REVAMPED RELATIONSHIPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JALISSA REYNOLDS LCPC (THERAPIST/ OWNER)
(773) 517-3504
Entity
Organization
Contact information
Practice address
18161 MORRIS AVE STE 202, HOMEWOOD, IL 60430-2141
(708) 637-6760
Mailing address
631 N CARROLL PKWY APT 209, GLENWOOD, IL 60425-1161
(773) 517-3504
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
09/02/2026
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