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General NPI Number Information
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NPI Number | 1700720968
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Entity Type | Organization
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Legal Business Name | EQ COUNSELING AND WELLNESS
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 4018 S MICHIGAN AVE APT 4S
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City | CHICAGO
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State | IL
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Zip | 60653-2100
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Country | US
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Telephone | 219-688-0014
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Fax |
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Provider Business Mailing Address
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Address Line | 192 N WELLS ST # 3009
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City | CHICAGO
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State | IL
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Zip | 60606-1848
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER AND CEO
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Name | KEENEN ELLIOT STEVENSON
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Credential | LCSW
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Telephone | 219-688-0014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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