Provider Demographics
NPI:1609240456
Name:HEALING CENTER FOR BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:HEALING CENTER FOR BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SKAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-586-9303
Mailing Address - Street 1:1005 W LARAWAY RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2461
Mailing Address - Country:US
Mailing Address - Phone:708-586-9303
Mailing Address - Fax:866-293-0414
Practice Address - Street 1:15127 S 73RD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4398
Practice Address - Country:US
Practice Address - Phone:708-586-9303
Practice Address - Fax:866-293-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty