Healthcare Provider Details

I. General information

NPI: 1497661912
Provider Name (Legal Business Name): HEALING SPACE COUNSELING AND CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 N CUNNINGHAM AVE
URBANA IL
61802-1816
US

IV. Provider business mailing address

2702 N SKYLINE DR
URBANA IL
61802-7835
US

V. Phone/Fax

Practice location:
  • Phone: 217-974-6333
  • Fax:
Mailing address:
  • Phone: 217-974-6333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHACIARRA HAMILTON
Title or Position: OWNER
Credential: PSY.D.
Phone: 217-974-6333