Healthcare Provider Details

I. General information

NPI: 1194649335
Provider Name (Legal Business Name): GRACEFUL TRANSFORMATION COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W GALENA BLVD STE 107
AURORA IL
60506-3948
US

IV. Provider business mailing address

1147 BROOK FOREST AVE STE 772
SHOREWOOD IL
60404-8845
US

V. Phone/Fax

Practice location:
  • Phone: 815-712-4000
  • Fax:
Mailing address:
  • Phone: 815-712-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. JANA HAYES
Title or Position: OWNER, MANAGER
Credential: LCSW
Phone: 815-616-4700