Healthcare Provider Details
I. General information
NPI: 1740155746
Provider Name (Legal Business Name): PROSPECT MUSIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
657 E GOLF RD STE 301
ARLINGTON HEIGHTS IL
60005-4071
US
IV. Provider business mailing address
657 E GOLF RD STE 301
ARLINGTON HEIGHTS IL
60005-4071
US
V. Phone/Fax
- Phone: 847-580-3443
- Fax:
- Phone: 847-580-3443
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225A00000X |
| Taxonomy | Music Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LOREN
ANN
GOODMAN
Title or Position: CEO
Credential: MA, LPMT, MT-BC
Phone: 224-628-8723