Healthcare Provider Details

I. General information

NPI: 1023949369
Provider Name (Legal Business Name): KJ COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2917 WILLIAMS DR
WOODRIDGE IL
60517-1921
US

IV. Provider business mailing address

2917 WILLIAMS DR
WOODRIDGE IL
60517-1921
US

V. Phone/Fax

Practice location:
  • Phone: 224-805-7004
  • Fax:
Mailing address:
  • Phone: 224-805-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KAYTLYN M JOHNSON
Title or Position: OWNER
Credential: LCPC
Phone: 224-805-7004