Nova Luna Behavior Health Services LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

NOVA LUNA BEHAVIOR HEALTH SERVICES LLC

Practice address

1653 W 35TH St
Chicago, IL 60609-1309

Phone

(773) 615-5415

NPI assigned

Jun 25, 2024

Last updated

Aug 25, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jessica Carrillo-GuerreroNPI 1073257770

Title

Owner

Phone

(773) 615-5415

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Carrillo-Guerrero, LCPC

  • Professional Counselor
  • Chicago, IL
  • NPI 1073257770
  Medicare reassignment NPD Authorized official
• Jana Gillespie

  • Social Worker
  • Chicago, IL
  • NPI 1174154249
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756080000000",
    "number": "1417792284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W 35TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091309",
            "telephone_number": "773-615-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W 35TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091309",
            "telephone_number": "773-615-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA LUNA BEHAVIOR HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2025-08-25",
        "certification_date": "2025-07-30",
        "status": "A",
        "authorized_official_last_name": "CARRILLO-GUERRERO",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-615-5415"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.