MEDICARE: RECIPROCAL GROWTH THERAPY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1851254114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RECIPROCAL GROWTH THERAPY PLLC

Provider Business Mailing Address
First Line	:	1149 W FARWELL AVE APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-6508
Country	:	US
Telephone Number	:	872-331-4607
Fax Number	:

Provider Business Practice Location Address
First Line	:	1149 W FARWELL AVE APT 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-6508
Country	:	US
Telephone Number	:	303-519-9333
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MORGAN MCCOWAN
Credential	:	PSYD
Telephone Number	:	872-331-4607

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	05/08/2026

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