Organization
HEALTHY SOUL TALK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY THOMAS LCPC (PRINCIPLE OWNER)
(708) 483-8455
Entity
Organization
Contact information
Practice address
1701 S 1ST AVE STE 307, MAYWOOD, IL 60153-2419
(708) 483-8455
(708) 776-4717
Mailing address
1701 S 1ST AVE STE 307, MAYWOOD, IL 60153-2419
(708) 483-8455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
04/11/2018
Last updated
07/31/2023
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