Provider Demographics
NPI:1578800744
Name:THE LIGHT OF THE HEART: A COMMUNITY ART THERAPY PROJECT
Entity Type:Organization
Organization Name:THE LIGHT OF THE HEART: A COMMUNITY ART THERAPY PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HEDLUND
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:630-486-4078
Mailing Address - Street 1:2240 BANNISTER LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-6006
Mailing Address - Country:US
Mailing Address - Phone:640-486-4078
Mailing Address - Fax:630-281-5374
Practice Address - Street 1:2240 BANNISTER LN
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-6006
Practice Address - Country:US
Practice Address - Phone:640-486-4078
Practice Address - Fax:630-281-5374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008048251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health