LAVENDER MOON SELF ILLUMINATING COUNSELING SERVICES PLLC
NPI 1558189076
Clinic/Center - Adult Mental Health in Chicago, IL

Q: What is Lavender Moon Self Illuminating Counseling Services PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

Active since October 02, 2024

1400 W RANDOLPH ST UNIT 1002, CHICAGO, IL 60607(708) 918-4456 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lavender Moon Self Illuminating Counseling Services Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAVENDER MOON SELF ILLUMINATING COUNSELING SERVICES PLLC (NPI 1558189076) is a healthcare organization registered as an adult mental health in Chicago, Illinois and active in the NPI registry since October 2024. The organization maintains a secondary practice location in Chicago and lists Taylor Quinn, Owner/lcpc, as its authorized official.

NPPES Registry Identity

NPI1558189076

Entity TypeOrganization

Primary Taxonomy261QM0850X

Legal Business NameLAVENDER MOON SELF ILLUMINATING COUNSELING SERVICES PLLC

Location Address1400 W RANDOLPH ST UNIT 1002Chicago, IL 60607-1433

Mailing Address11430 Lakebrook CtOrland Park, IL 60467-8506

Phone(708) 918-4456

Organization SubpartNo

Authorized OfficialTaylor QuinnOwner/lcpc · (708) 504-2528

Enumeration DateOctober 2, 2024

Last NPPES UpdateApril 17, 2025

NPPES CertifiedApril 17, 2025

✔ NPI 1558189076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities

Taxonomy Code261QM0850X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

1400 W RANDOLPH ST UNIT 1002, Chicago, IL 60607

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Secondary Practice Location 1

Location 11858 W Chicago Ave Apt 3RChicago, IL 60622-5547 · Phone (708) 504-2528

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLOR MARIE QUINN

Counselor

1400 W RANDOLPH ST UNIT 1002
CHICAGO, IL 60607

Cook County (708) 918-4456

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lavender Moon Self Illuminating Counseling Services PLLC's NPI number?

The NPI number for Lavender Moon Self Illuminating Counseling Services PLLC is 1558189076. It was assigned to this organization in the NPPES registry on October 2, 2024.

Where is Lavender Moon Self Illuminating Counseling Services PLLC located?

Lavender Moon Self Illuminating Counseling Services PLLC is located at 1400 W Randolph St Unit 1002, Chicago, IL 60607. The listed phone number is (708) 918-4456.

What is Lavender Moon Self Illuminating Counseling Services PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Lavender Moon Self Illuminating Counseling Services PLLC was last updated on April 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.