=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841098993
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOVEN WELLNESS PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2025
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2132 N 76TH CT
-----------------------------------------------------
City | ELMWOOD PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60707-3005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-444-0904
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2132 N 76TH CT
-----------------------------------------------------
City | ELMWOOD PARK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60707-3005
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-444-0904
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SHAINA ROSE HELM
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 312-444-0904
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------