Jade R Bryant-Moore, LPC
Student in an Organized Health Care Education/Training Program in Chicago, IL. Individual provider (NPI-1).
NPI number1104764232
StatusActive
Last updated in NPPESMay 27, 2026
Details
- NPI
- 1104764232
- Entity type
- Individual (NPI-1)
- Name
- Ms. Jade R Bryant-Moore
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 23, 2026
- Certification date
- May 27, 2026
- Last updated
- May 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
333 N Michigan Ave Ste 1400Chicago, IL 60601-4011
Phone 312-815-9660
Mailing address
329 N Genesee StWaukegan, IL 60085-4205
Phone 847-623-1730 · Fax 847-623-1733
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