Healthcare Provider Details

I. General information

NPI: 1275455412
Provider Name (Legal Business Name): ESSEX COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4752 S SHIELDS AVE
CHICAGO IL
60609-4529
US

IV. Provider business mailing address

2501 CHATHAM RD STE N
SPRINGFIELD IL
62704-4188
US

V. Phone/Fax

Practice location:
  • Phone: 312-731-3381
  • Fax:
Mailing address:
  • Phone: 312-731-3381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MR. JOVAN MAURICE CHANDLER
Title or Position: LCPC
Credential: MA
Phone: 312-731-3381