Healthcare Provider Details

I. General information

NPI: 1306711163
Provider Name (Legal Business Name): GROWING TOGETHER THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 MANCHESTER RD BLDG A, STE 400-A
WHEATON IL
60187
US

IV. Provider business mailing address

2100 MANCHESTER RD BUILDING A
WHEATON IL
60187
US

V. Phone/Fax

Practice location:
  • Phone: 630-445-1918
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JESSICA KOCUM
Title or Position: OWNER
Credential: LMFT
Phone: 630-445-1918