Healthcare Provider Details

I. General information

NPI: 1932034386
Provider Name (Legal Business Name): TURTLE BLOOM THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 AVALON WAY
MINOOKA IL
60447-4594
US

IV. Provider business mailing address

2405 ESSINGTON RD STE B
JOLIET IL
60435-1204
US

V. Phone/Fax

Practice location:
  • Phone: 708-921-6488
  • Fax:
Mailing address:
  • Phone: 708-921-6488
  • Fax:

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: FELICIA FRAZIER
Title or Position: THERAPIST/MANAGER
Credential: LCSW
Phone: 708-921-6488