Light Side Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

LIGHT SIDE THERAPY LLC

Practice address

1845 E Rand Rd Ste L109
Arlington Heights, IL 60004-4375

Phone

(773) 490-8863

NPI assigned

Sep 6, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carol Regenhardt

Title

Administrative Assistant

Phone

(773) 490-8863

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662422400000",
    "number": "1003537341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1845 E RAND RD STE L109",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600044375",
            "telephone_number": "773-490-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 E RAND RD STE L109",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600044375",
            "telephone_number": "773-490-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHT SIDE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A",
        "authorized_official_last_name": "REGENHARDT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "773-490-8863"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.