Provider Demographics
NPI:1437621422
Name:HEALTH AND HEALING THERAPY LLC
Entity Type:Organization
Organization Name:HEALTH AND HEALING THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KONCILJA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW CADC ICGC-II
Authorized Official - Phone:630-864-7267
Mailing Address - Street 1:850 W BARTLETT RD STE 14C
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4454
Mailing Address - Country:US
Mailing Address - Phone:630-864-7267
Mailing Address - Fax:630-596-0743
Practice Address - Street 1:850 W. BARTLETT RD
Practice Address - Street 2:STE 14C
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4454
Practice Address - Country:US
Practice Address - Phone:630-864-7267
Practice Address - Fax:630-596-0743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-01
Last Update Date:2020-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty