Healthcare Provider Details

I. General information

NPI: 1891614509
Provider Name (Legal Business Name): TOTAL ENRICHMENT SERVICES INC.-NFP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1119 N MASON AVE
CHICAGO IL
60651-2507
US

IV. Provider business mailing address

1119 N MASON AVE
CHICAGO IL
60651-2507
US

V. Phone/Fax

Practice location:
  • Phone: 773-680-9699
  • Fax:
Mailing address:
  • Phone: 773-680-9699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER JACKSON C CHRISTOPHER JACKSON
Title or Position: CFO
Credential: JACKSON
Phone: 773-680-9699