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General NPI Number Information
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NPI Number | 1326816240
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Entity Type | Individual
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Provider Name | HEBA I QANDEEL-KISHTA MA, CADC I
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Gender | Female
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 7625 BROOKSIDE GLEN DR
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City | TINLEY PARK
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State | IL
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Zip | 60487-5197
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Country | US
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Telephone | 312-371-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 7625 BROOKSIDE GLEN DR
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City | TINLEY PARK
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State | IL
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Zip | 60487-5197
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Country | US
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Telephone | 312-371-9222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 171R00000X
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Taxonomy Name | Interpreter
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 1744G0900X
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Taxonomy Name | Graphics Designer
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 1744R1102X
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Taxonomy Name | Research Study Specialist
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License Number |
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License Number State |
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Taxonomy #13
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #14
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #15
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 33823
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License Number State | IL
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