Provider Demographics
NPI:1770336521
Name:OPAL THERAPY FOR HEALING PLLC
Entity type:Organization
Organization Name:OPAL THERAPY FOR HEALING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MEAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:872-356-1377
Mailing Address - Street 1:1440 W TAYLOR ST # 1718
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4623
Mailing Address - Country:US
Mailing Address - Phone:872-356-1377
Mailing Address - Fax:
Practice Address - Street 1:708 W BITTERSWEET PLACE UNIT 412
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:872-356-1377
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty