Healthcare Provider Details

I. General information

NPI: 1679384838
Provider Name (Legal Business Name): WELLNESS TRANSFORMED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3S101 ROCKWELL ST UNIT 462
WARRENVILLE IL
60555-2963
US

IV. Provider business mailing address

3S101 ROCKWELL ST UNIT 462
WARRENVILLE IL
60555-2963
US

V. Phone/Fax

Practice location:
  • Phone: 630-286-9407
  • Fax:
Mailing address:
  • Phone: 630-442-0050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JENALEIGH TURNER
Title or Position: OFFICER
Credential: LCSW
Phone: 630-442-0050