Provider Demographics
NPI:1023665999
Name:ALW GROUP GROW
Entity type:Organization
Organization Name:ALW GROUP GROW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PYSCHOTHERAPIST/CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYUM-GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC
Authorized Official - Phone:331-305-4009
Mailing Address - Street 1:200 E 5TH AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3173
Mailing Address - Country:US
Mailing Address - Phone:331-305-4009
Mailing Address - Fax:
Practice Address - Street 1:200 E 5TH AVE STE 109
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3173
Practice Address - Country:US
Practice Address - Phone:331-305-4009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-24
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty