Healthcare Provider Details

I. General information

NPI: 1174433973
Provider Name (Legal Business Name): HEALING SUNSHINE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12512 S MELVINA AVE
PALOS HEIGHTS IL
60463-1844
US

IV. Provider business mailing address

12512 S MELVINA AVE
PALOS HEIGHTS IL
60463-1844
US

V. Phone/Fax

Practice location:
  • Phone: 708-935-0749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE DARIA CUSACK
Title or Position: LCPC
Credential:
Phone: 708-935-0749