| Soulhealing-psychotherapy, Llc | |
|
101 N Marion St Oak Park IL 60301-1167 | |
| (708) 622-5757 | |
| Not Available |
| Full Name | Soulhealing-psychotherapy, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 101 N Marion St, Oak Park, Illinois |
| Authorized Official Name and Position | Kirsten Kingsley (COUNSELING PSYCHOLOGIST) |
| Authorized Official Contact | 7086225757 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulhealing-psychotherapy, Llc 9200 W Mcdowell Rd Unit 156 Phoenix AZ 85037-1189 Ph: (630) 788-9898 | Soulhealing-psychotherapy, Llc 101 N Marion St Oak Park IL 60301-1167 Ph: (708) 622-5757 |
| NPI Number | 1366287112 |
|---|---|
| Provider Enumeration Date | 06/25/2024 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Medicare PECOS PAC ID | 8123553849 |
|---|---|
| Medicare Enrollment ID | O20241119000359 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366287112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | Kirsten Kingsley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730530734 PECOS PAC ID: 5597290213 Enrollment ID: I20241119000334 |
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