| Graceful Growth Counseling Services | |
|
171 N Aberdeen St Ste 400 Chicago IL 60607-1670 | |
| (773) 459-1237 | |
| Not Available |
| Full Name | Graceful Growth Counseling Services |
|---|---|
| Speciality | Counselor |
| Location | 171 N Aberdeen St Ste 400, Chicago, Illinois |
| Authorized Official Name and Position | Tiffany Marie Stevens (CLINICAL DIRECTOR) |
| Authorized Official Contact | 7734591237 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Graceful Growth Counseling Services 171 N Aberdeen St Ste 400 Chicago IL 60607-1670 Ph: (773) 459-1237 | Graceful Growth Counseling Services 171 N Aberdeen St Ste 400 Chicago IL 60607-1670 Ph: (773) 459-1237 |
| NPI Number | 1891355376 |
|---|---|
| Provider Enumeration Date | 06/18/2019 |
| Last Update Date | 09/05/2024 |
| Certification Date | 09/05/2024 |
| Medicare PECOS PAC ID | 6002254414 |
|---|---|
| Medicare Enrollment ID | O20240404001676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891355376 | NPI | - | NPPES |
| 1114457622 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Tiffany M Stevens |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114457611 PECOS PAC ID: 6901244318 Enrollment ID: I20240404001853 |
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