Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lavender Moon Self Illuminating Counseling Services PLLC

Organization Adult Mental Health Clinic/Center · NPI 1558189076

Lavender Moon Self Illuminating Counseling Services PLLC is an Adult Mental Health Clinic/Center in Chicago, Illinois. Works from 2 locations. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1400 W Randolph St Unit 1002
Chicago, IL 60607-1433
Phone: (708) 918-4456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1858 W Chicago Ave Apt 3r, Chicago, IL 60622-5547 — (708) 504-2528

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X

Record details

NPI number1558189076
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Taylor Quinn — Owner/Lcpc · (708) 504-2528
NPI enumeratedOctober 2, 2024
Last updated in NPPESApril 17, 2025
Certification dateApril 17, 2025
Mailing address11430 Lakebrook Ct, Orland Park, IL 60467-8506

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