Healthcare Provider Details

I. General information

NPI: 1134031701
Provider Name (Legal Business Name): BEYOND WORDS ART THERAPY COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9736 N MANITO RD
MANITO IL
61546-8548
US

IV. Provider business mailing address

9736 N MANITO RD
MANITO IL
61546-8548
US

V. Phone/Fax

Practice location:
  • Phone: 309-839-9334
  • Fax:
Mailing address:
  • Phone: 309-839-9334
  • 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: KAYLA ELIZABETH GROBE
Title or Position: OWNER/CLINICIAN
Credential: MA,LCPC,ATR
Phone: 309-839-9334