Healthcare Provider Details

I. General information

NPI: 1114857224
Provider Name (Legal Business Name): G.O.A.L. MENTAL WELLNESS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ENTERPRISE DR STE C
JOLIET IL
60431-8840
US

IV. Provider business mailing address

4300 ENTERPRISE DR STE C
JOLIET IL
60431-8840
US

V. Phone/Fax

Practice location:
  • Phone: 815-421-3005
  • Fax: 815-421-3050
Mailing address:
  • Phone: 815-421-3005
  • Fax: 815-421-3050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MAYA AKAI MONET WINTERS
Title or Position: OWNER
Credential: LCPC
Phone: 815-421-3005