Healthcare Provider Details

I. General information

NPI: 1740105469
Provider Name (Legal Business Name): ASCEND THERAPY AND WELLNESS SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N WASHINGTON ST
NAPERVILLE IL
60563-2724
US

IV. Provider business mailing address

2529 LAMBERT DR
AURORA IL
60503-3620
US

V. Phone/Fax

Practice location:
  • Phone: 331-256-5405
  • Fax:
Mailing address:
  • Phone: 630-913-3000
  • Fax:

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: KIJUANA BOULRECE
Title or Position: CLINICAL PSYCHOTHERAPIST
Credential:
Phone: 331-256-5405