Provider Demographics
NPI:1285036343
Name:BEYOND HEALING
Entity type:Organization
Organization Name:BEYOND HEALING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CFT, MA
Authorized Official - Phone:708-837-3722
Mailing Address - Street 1:13728 W CAREFREE DR
Mailing Address - Street 2:
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-8655
Mailing Address - Country:US
Mailing Address - Phone:708-837-3722
Mailing Address - Fax:
Practice Address - Street 1:13728 W CAREFREE DR
Practice Address - Street 2:
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-8655
Practice Address - Country:US
Practice Address - Phone:708-837-3722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-006920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty