Healthcare Provider Details

I. General information

NPI: 1093479958
Provider Name (Legal Business Name): NURTURE THROUGH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7146 183RD ST STE 123
TINLEY PARK IL
60477-3933
US

IV. Provider business mailing address

7146 183RD ST STE 123
TINLEY PARK IL
60477-3933
US

V. Phone/Fax

Practice location:
  • Phone: 708-314-8416
  • Fax:
Mailing address:
  • Phone: 708-314-8416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MEGHAN BURCL
Title or Position: OWNER
Credential: LCSW, CADC
Phone: 708-314-8416