Provider Demographics
NPI:1407734619
Name:LOVE & HEALING COUNSELING CENTER PLLC
Entity type:Organization
Organization Name:LOVE & HEALING COUNSELING CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARCIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:MANGUN-CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-474-3471
Mailing Address - Street 1:18161 MORRIS AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2141
Mailing Address - Country:US
Mailing Address - Phone:773-934-0342
Mailing Address - Fax:
Practice Address - Street 1:18161 MORRIS AVE STE 201
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2141
Practice Address - Country:US
Practice Address - Phone:773-934-0342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty