NPIMap

Organization Active NPI

Healing Hands Resource Center

Doing business as Healing Hands Resource Center Belleville

  • Psychiatry Physician
  • Belleville, IL
National Provider Identifier
1053921296
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
HEALING HANDS RESOURCE CENTER
Doing business as
Healing Hands Resource Center Belleville
Practice address
6607 W Main St
Belleville, IL 62223-3025
Phone
(773) 467-6967
Fax
(773) 572-9553
NPI assigned
Aug 3, 2020
Last updated
Aug 5, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALING HANDS RESOURCE CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Authorized official

Name
Dr. Valencia Green, MD, MPH
Title
Ceo
Phone
(773) 467-6967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

6607 W Main St
Belleville, IL 62223-3025

Mailing address

1022 N Kedzie Ave
Chicago, IL 60651-4128
Phone (773) 467-6967

Other practice location 1

1652 Lebanon Ave
Belleville, IL 62221-2466
Phone (773) 467-6967

Other names 1

  • Healing Hands Resource Center Belleville Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drgreen4935@sbcglobal.net

National Provider Directory

National Provider Directory
Tax ID family
Healing Hands Resource Center11 organizations share this tax ID, including this one
Part of
Healing Hands Resource Center

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1652 Lebanon Ave
Belleville, IL 62221

6607 W Main St
Belleville, IL 62223

NPI Registry JSON

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

{
    "created_epoch": "1596412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596585600000",
    "number": "1053921296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514128",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6607 W MAIN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233025",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1652 Lebanon Ave",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622212466",
            "country_code": "US",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALING HANDS RESOURCE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALING HANDS RESOURCE CENTER",
        "enumeration_date": "2020-08-03",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VALENCIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-467-6967",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drgreen4935@sbcglobal.net",
            "affiliation": "N",
            "address_1": "1652 Lebanon Ave",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622212466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Healing Hands Resource Center Belleville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healing Hands Resource Center Belleville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; 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.