Organization Active NPI

Healthy Soul Talk LLC

  • Mental Health Counselor
  • Maywood, IL
National Provider Identifier
1326545773
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HEALTHY SOUL TALK LLC
Practice address
1701 S 1St Ave Ste 307
Maywood, IL 60153-2419
Phone
(708) 483-8455
Fax
(708) 776-4717
NPI assigned
Apr 11, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Dr. Kimberly Thomas, LCPCNPI 1851701825
Title
Principle Owner
Phone
(708) 483-8455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

1701 S 1St Ave Ste 307
Maywood, IL 60153-2419

Mailing address

1701 S 1St Ave Ste 307
Maywood, IL 60153-2419
Phone (708) 483-8455

National Provider Directory

National Provider Directory

Locations

1701 S 1st Ave
Ste 307
Maywood, IL 60153
Phone (708) 483-8455

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1326545773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S 1ST AVE STE 307",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532419",
            "telephone_number": "708-483-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S 1ST AVE STE 307",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532419",
            "telephone_number": "708-483-8455",
            "fax_number": "708-776-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY SOUL TALK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRINCIPLE OWNER",
        "authorized_official_telephone_number": "708-483-8455",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.