Healthcare Provider Details

I. General information

NPI: 1023953585
Provider Name (Legal Business Name): THERAPY CUBED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 SCOTT CRES
FLOSSMOOR IL
60422-1722
US

IV. Provider business mailing address

1516 SCOTT CRES
FLOSSMOOR IL
60422-1722
US

V. Phone/Fax

Practice location:
  • Phone: 312-282-9875
  • Fax:
Mailing address:
  • Phone: 312-282-9875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMESA PRUITT
Title or Position: CEO
Credential:
Phone: 312-282-9875