NPIMap

Organization Active NPI

Revamped Relationships

  • Mental Health Counselor
  • Homewood, IL
National Provider Identifier
1952062770
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
REVAMPED RELATIONSHIPS
Practice address
18161 Morris Ave Ste 202
Homewood, IL 60430-2141
Phone
(708) 637-6760
NPI assigned
Jan 4, 2022
Last updated
Sep 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Authorized official

Name
Jalissa Reynolds, LCPCNPI 1417254004
Title
Therapist/ Owner
Phone
(773) 517-3504

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU
Mental Health Counselor 101YM0800X NU Primary
Professional Counselor 101YP2500X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Marriage & Family Therapist 106H00000X NU

Addresses

Primary practice location

18161 Morris Ave Ste 202
Homewood, IL 60430-2141

Mailing address

631 N Carroll Pkwy Apt 209
Glenwood, IL 60425-1161
Phone (773) 517-3504

National Provider Directory

National Provider Directory

Locations

18161 Morris Ave
Ste 202
Homewood, IL 60430
Phone (708) 637-6760

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788307200000",
    "number": "1952062770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 N CARROLL PKWY APT 209",
            "city": "GLENWOOD",
            "state": "IL",
            "postal_code": "604251161",
            "telephone_number": "773-517-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18161 MORRIS AVE STE 202",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302141",
            "telephone_number": "708-637-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVAMPED RELATIONSHIPS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "JALISSA",
        "authorized_official_title_or_position": "THERAPIST/ OWNER",
        "authorized_official_telephone_number": "773-517-3504",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.