Provider Demographics
NPI:1871222125
Name:HEALTHY HUE LLC
Entity Type:Organization
Organization Name:HEALTHY HUE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-540-1179
Mailing Address - Street 1:209 E 42ND ST APT 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-4857
Mailing Address - Country:US
Mailing Address - Phone:773-540-1179
Mailing Address - Fax:
Practice Address - Street 1:209 E 42ND ST APT 3E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-4857
Practice Address - Country:US
Practice Address - Phone:773-540-1179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL180.013708OtherSTATE LICENSE