Healthcare Provider Details

I. General information

NPI: 1801741087
Provider Name (Legal Business Name): ASHLEY GRAVES THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 JACKSON AVE
RIVER FOREST IL
60305-1415
US

IV. Provider business mailing address

937 JACKSON AVE
RIVER FOREST IL
60305-1415
US

V. Phone/Fax

Practice location:
  • Phone: 773-251-1494
  • Fax: 773-251-1494
Mailing address:
  • Phone: 773-251-1494
  • Fax: 773-251-1494

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: ASHLEY GRAVES
Title or Position: THERAPIST
Credential: LCSW
Phone: 773-251-1494