Eden Behavioral Health LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

EDEN BEHAVIORAL HEALTH LLC

Practice address

81 Harmony LN
Romeoville, IL 60446-4296

Phone

(708) 967-3092

NPI assigned

Oct 28, 2024

Organization subpart

No

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

Authorized official

Name

Hidayat Shah, LCSWNPI 1184450116

Title

Owner

Phone

(708) 967-3092

Specialties & licenses 4

Addresses

Locations

Practitioners 2

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

• Hidayat Shah, LSW

  • Clinical Social Worker
  • Naperville, IL
  • NPI 1184450116
  NPD Authorized official
• Ashley Mitchell, LCSW

  • Clinical Social Worker
  • Hinsdale, IL
  • NPI 1578436747
  NPD (past)

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

{
    "created_epoch": "1730073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1861214272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HARMONY LN",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604464296",
            "telephone_number": "708-967-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HARMONY LN",
            "city": "ROMEOVILLE",
            "state": "IL",
            "postal_code": "604464296",
            "telephone_number": "708-967-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-28",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "HIDAYAT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-967-3092",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabelle Marie De Guzman Dujali, CNA
• Marlene Marie Dunleavy, ED.S
• Catherine Dupee, CCC-SLP
• E Zee Urgent Care PLLC
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• Shelley M Egeland, LCPC
• Rebecca Eggers, ATC
• Laura Emmanuelli
• Empower Physical Therapy, S.C.

• Clinical Social Worker in Romeoville, IL
• Providers in Romeoville, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.