Provider Demographics
NPI:1003335290
Name:HEALTHY THOUGHTS WELLNESS CENTER
Entity Type:Organization
Organization Name:HEALTHY THOUGHTS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:NEUKOMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-419-4713
Mailing Address - Street 1:2205 E UNIVERSITY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61802-2811
Mailing Address - Country:US
Mailing Address - Phone:217-419-4713
Mailing Address - Fax:
Practice Address - Street 1:2205 E UNIVERSITY AVE STE A
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61802-2811
Practice Address - Country:US
Practice Address - Phone:217-419-4713
Practice Address - Fax:217-419-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007459251S00000X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)