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Organization
GRACEFUL GROWTH COUNSELING SERVICES
Active
Organization
GRACEFUL GROWTH COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TIFFANY MARIE STEVENS LCPC (CLINICAL DIRECTOR)
(773) 459-1237
Entity
Organization
Contact information
Practice address
171 N ABERDEEN ST STE 400, CHICAGO, IL 60607-1670
(773) 459-1237
Mailing address
171 N ABERDEEN ST STE 400, CHICAGO, IL 60607-1670
(773) 459-1237
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114457622
—
IL
Enumeration date
06/18/2019
Last updated
09/05/2024
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