Healthcare Provider Details

I. General information

NPI: 1316882293
Provider Name (Legal Business Name): EQ COUNSELING AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N MICHIGAN AVE STE 810
CHICAGO IL
60601-5902
US

IV. Provider business mailing address

192 N WELLS ST # 3009
CHICAGO IL
60606-1848
US

V. Phone/Fax

Practice location:
  • Phone: 219-688-0014
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. KEENEN ELLIOT STEVENSON
Title or Position: CO-FOUNDER/ CEO
Credential: LCSW
Phone: 219-688-0014