Provider Demographics
NPI:1659679207
Name:BEYOND HEALING
Entity Type:Organization
Organization Name:BEYOND HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC, NCC, CFT
Authorized Official - Phone:708-837-3722
Mailing Address - Street 1:7600 W. COLLEGE DR.
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-837-3722
Mailing Address - Fax:708-590-6791
Practice Address - Street 1:7600 W COLLEGE DR
Practice Address - Street 2:1ST FLOOR
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1001
Practice Address - Country:US
Practice Address - Phone:708-837-3722
Practice Address - Fax:708-590-6791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL18000692251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management