Healthcare Provider Details

I. General information

NPI: 1285562918
Provider Name (Legal Business Name): HOPESHIFT THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 SOUTHFIELD DR APT 3
AURORA IL
60504-5341
US

IV. Provider business mailing address

1552 S ROUTE 59
NAPERVILLE IL
60564-5941
US

V. Phone/Fax

Practice location:
  • Phone: 630-930-1657
  • Fax:
Mailing address:
  • Phone: 630-930-1657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: RYAN MUIR
Title or Position: MEMBER
Credential: MS, LCPC, CADC
Phone: 630-930-1657