Individual
JESSICA L BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1525 E 53RD ST STE 901, CHICAGO, IL 60615-4572
(773) 234-1839
Mailing address
1525 E 53RD ST STE 901, CHICAGO, IL 60615-4572
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180.009600
IL
Other
Enumeration date
12/12/2012
Last updated
10/09/2024
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