Healthcare Provider Details

I. General information

NPI: 1356093587
Provider Name (Legal Business Name): TOUCH OF WHOLENESS PSYCHOLOGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2022
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 TOWN CENTER RD # 520
MATTESON IL
60443-2204
US

IV. Provider business mailing address

600 TOWN CENTER RD # 520
MATTESON IL
60443-2204
US

V. Phone/Fax

Practice location:
  • Phone: 708-295-7427
  • Fax:
Mailing address:
  • Phone: 708-295-7427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KEAJUANIS MALENA
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: PSY.D.
Phone: 708-275-9427