GRACEFUL THERAPY, LLC (NPI# 1932687332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932687332 |
| Entity Type | Organization |
| Organization Name | GRACEFUL THERAPY, LLC |
| Practice Address |
2683 Route 34 Oswego IL 60543 |
| Mailing Address |
2683 Route 34 Oswego IL 60543-8577 |
| Practice Telephone | 6307339108 |
| Practice Fax Number | 6309124242 |
| Mailing Telephone | 6307339108 |
| Mailing Fax Number | 6309124242 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | KATHRYN FISH (OWNER & THERAPIST) |
| Authorized Official Telephone | 6307339108 |
| Authorized Official Credential | LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | 166.001164 | IL | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 123 W Washington St Ste B-08, Oswego, IL 605438214 | 6307339108 |
| Street Address |
2683 ROUTE 34 |
| City | OSWEGO |
| State | IL |
| Zip Code | 60543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962046615 | Shannon Carlson | Counselor | 2683 Route 34, Oswego, IL 60543-8577 | 2019-11-05 |
| 1881158095 | Ashley Miller | Marriage & Family Therapist | 2683 Route 34, Oswego, IL 60543-8577 | 2019-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235669763 | Elizabeth Lassandrello Bremner | Counselor | 123 W. Washington St, Oswego, IL 60543 | 2017-06-18 |
| 1205365699 | The Wisdom Shuttle, Inc. | Non-emergency Medical Transport (VAN) | 234 Springbrook Trail South, Oswego, IL 60543 | 2017-06-08 |
| 1477003267 | Smart Choice Mri, LLC | Clinic/Center | 2752 Us Highway 34, Oswego, IL 60543 | 2016-10-05 |
| 1033588686 | George Pearah | Internal Medicine | 408 Sudbury Circle, Oswego, IL 60543 | 2015-09-24 |
| 1619375078 | Kathryn Elyse Fish | Marriage & Family Therapist | 123 W Washington St Ste B-08, Oswego, IL 60543 | 2014-12-16 |
| 1821410713 | Amanda Southwell | Social Worker | 512 Affirmed Dr, Oswego, IL 60543 | 2014-01-10 |
| 1073852158 | James A. Sandrolini | Surgery | 245 Gray's Dr., Oswego, IL 60543 | 2013-02-08 |
| 1649514035 | Kelly L Mangler | Pharmacist | 2030 Route 34, Oswego, IL 60543 | 2012-11-26 |
| 1730483280 | Little Talkers, Speech and Language Therapy, LLC | Speech-Language Pathologist | 809 Barton Drive, Oswego, IL 60543 | 2010-12-27 |
| 1275847204 | Oswego East Dental Associates | Dentist | 1768 Douglas Rd, Oswego, IL 60543 | 2010-08-02 |
| Find all providers in zip 60543 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588138812 | Cristen Taylor | Counselor | 123 W Washington St # B08, Oswego, IL 60543-8214 | 2019-01-21 |
| 1235669763 | Elizabeth Lassandrello Bremner | Counselor | 123 W. Washington St, Oswego, IL 60543 | 2017-06-18 |
| 1679857577 | Melanie Anne Dewey | Counselor | 298 Waterbury Cir, Oswego, IL 60543-7920 | 2011-10-11 |
| 1053613083 | Kelly M Fixmer | Counselor | 105 Theodore Dr, Suite B-2, Oswego, IL 60543-6031 | 2010-11-23 |
| 1225367618 | Kathryn R Howe | Counselor | 5 E Washington Street, Suite 2d, Oswego, IL 60543 | 2009-12-14 |
| 1962046615 | Shannon Carlson | Counselor | 2683 Route 34, Oswego, IL 60543-8577 | 2019-11-05 |
| 1679137582 | Stephanie Estell Wollert | Counselor | 123 W Washington St Ste 321, Oswego, IL 60543-8297 | 2019-04-25 |
| 1730645409 | Kristy Cahill | Counselor | 62 S Madison St, Oswego, IL 60543-9806 | 2019-02-18 |
| 1477021368 | Anna Themanson | Counselor | 123 W Washington St Ste B-08, Oswego, IL 60543-8214 | 2018-11-08 |
| 1518404367 | Jessica Elise Johnson Berrios | Counselor | 123 W Washington St, Suite 321, Oswego, IL 60543-8214 | 2017-01-31 |
| Find all providers in OSWEGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.