Healthcare Provider Details

I. General information

NPI: 1720999584
Provider Name (Legal Business Name): GROUNDED THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 OPUS PL STE 110
DOWNERS GROVE IL
60515-1164
US

IV. Provider business mailing address

1431 OPUS PL STE 110
DOWNERS GROVE IL
60515-1164
US

V. Phone/Fax

Practice location:
  • Phone: 312-583-7171
  • Fax:
Mailing address:
  • Phone: 312-583-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: JENNIFER BONINO SOBOL
Title or Position: OWNER
Credential: PH.D, LCPC
Phone: 312-583-7171