Healthcare Provider Details

I. General information

NPI: 1871124784
Provider Name (Legal Business Name): NURTURE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 N RAVENSWOOD AVE STE 117
CHICAGO IL
60613-3570
US

IV. Provider business mailing address

2021 W MOFFAT ST
CHICAGO IL
60647-5516
US

V. Phone/Fax

Practice location:
  • Phone: 773-274-0700
  • Fax:
Mailing address:
  • Phone: 847-363-0628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JAMIE KREITER
Title or Position: LICENSED CLINICAL SOCIAL WORK
Credential: LCSW
Phone: 773-274-0700