Provider Demographics
NPI:1093160657
Name:FROM THE HEART COUNSELING
Entity Type:Organization
Organization Name:FROM THE HEART COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MADISEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-300-1502
Mailing Address - Street 1:22 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1818
Mailing Address - Country:US
Mailing Address - Phone:630-300-1502
Mailing Address - Fax:630-300-1502
Practice Address - Street 1:22 N 4TH ST
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1818
Practice Address - Country:US
Practice Address - Phone:630-300-1502
Practice Address - Fax:630-300-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490184481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty