Healthcare Provider Details

I. General information

NPI: 1386405876
Provider Name (Legal Business Name): THERAPY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2024
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 COVENTRY LANE SUITE 103
CRYSTAL LAKE IL
60014
US

IV. Provider business mailing address

453 COVENTRY LANE SUITE 103
CRYSTAL LAKE IL
60014
US

V. Phone/Fax

Practice location:
  • Phone: 224-829-0404
  • Fax:
Mailing address:
  • Phone: 224-829-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JOANN L HERMAN
Title or Position: CO-OWNER
Credential:
Phone: 224-829-0404