Healthcare Provider Details

I. General information

NPI: 1427988021
Provider Name (Legal Business Name): PEACEFUL MIND THERAPEUTICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2026
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 WARWICK DR
MATTESON IL
60443-2188
US

IV. Provider business mailing address

920 WARWICK DR
MATTESON IL
60443-2188
US

V. Phone/Fax

Practice location:
  • Phone: 708-288-1750
  • Fax: 708-288-1750
Mailing address:
  • Phone: 708-288-1750
  • Fax: 708-288-1750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SHEVA K WESLEY
Title or Position: CLINICAL SOCIAL WORKER
Credential: WESLEY-FRANKLIN
Phone: 708-288-1750