Provider Demographics
NPI:1295994150
Name:URBAN HEALING LTD.
Entity type:Organization
Organization Name:URBAN HEALING LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAMPIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-444-0044
Mailing Address - Street 1:100 N WALKUP AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-4383
Mailing Address - Country:US
Mailing Address - Phone:815-444-0044
Mailing Address - Fax:
Practice Address - Street 1:100 N WALKUP AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-4383
Practice Address - Country:US
Practice Address - Phone:815-444-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149008717251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health