Provider Demographics
NPI:1336757806
Name:TENDER HEARTS THERAPY, LTD
Entity Type:Organization
Organization Name:TENDER HEARTS THERAPY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-674-2657
Mailing Address - Street 1:5201 WASHINGTON ST STE 4
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5068
Mailing Address - Country:US
Mailing Address - Phone:630-674-2657
Mailing Address - Fax:
Practice Address - Street 1:5201 WASHINGTON ST STE 4
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5068
Practice Address - Country:US
Practice Address - Phone:630-674-2657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty