Organization
MIND BODY CONNECTIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY M HURST LCPC (OWNER)
(312) 543-2133
Entity
Organization
Contact information
Practice address
24W788 75TH ST, NAPERVILLE, IL 60565-1684
(312) 543-2133
Mailing address
3S101 ROCKWELL ST UNIT 247, WARRENVILLE, IL 60555-2948
(312) 543-2133
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
221700000X
Art Therapist
—
—
225600000X
Dance Therapist
—
—
261Q00000X
Clinic/Center
Primary
180-003221
IL
Other
Enumeration date
01/28/2013
Last updated
08/19/2023
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