Provider Demographics
NPI:1740155746
Name:PROSPECT MUSIC THERAPY LLC
Entity type:Organization
Organization Name:PROSPECT MUSIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPMT, MT-BC
Authorized Official - Phone:224-628-8723
Mailing Address - Street 1:657 E GOLF RD STE 301
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4071
Mailing Address - Country:US
Mailing Address - Phone:847-580-3443
Mailing Address - Fax:
Practice Address - Street 1:657 E GOLF RD STE 301
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4071
Practice Address - Country:US
Practice Address - Phone:847-580-3443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty