Healthcare Provider Details

I. General information

NPI: 1811839723
Provider Name (Legal Business Name): BLOOM IN GRACE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 SHERMAN AVE STE 318
EVANSTON IL
60201-5013
US

IV. Provider business mailing address

5510 LINCOLN AVE UNIT 405
MORTON GROVE IL
60053-3442
US

V. Phone/Fax

Practice location:
  • Phone: 312-724-5744
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: PAIGE LAUERMAN
Title or Position: OWNER/THERAPIST
Credential: LCSW
Phone: 219-577-5124