Healthcare Provider Details

I. General information

NPI: 1609665900
Provider Name (Legal Business Name): TRUCE THERAPY AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5127 N WOLCOTT AVE APT 1S
CHICAGO IL
60640-2657
US

IV. Provider business mailing address

5127 N WOLCOTT AVE APT 1S
CHICAGO IL
60640-2657
US

V. Phone/Fax

Practice location:
  • Phone: 815-978-9669
  • Fax:
Mailing address:
  • Phone: 815-978-9669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BROOKE BRACKETT
Title or Position: CLINICAL COUNSELOR
Credential: M.ED., LCPC
Phone: 815-978-9669