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General NPI Number Information
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NPI Number | 1578438370
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Entity Type | Organization
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Legal Business Name | SANTIAGO HEALING HAVEN, PLLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 11 N NORTHWEST HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-3330
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Country | US
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Telephone | 630-534-0658
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Fax |
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Provider Business Mailing Address
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Address Line | 7000 W FOREST PRESERVE DR # 1093
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City | NORRIDGE
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State | IL
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Zip | 60706-7123
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Country | US
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Telephone | 630-534-0658
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | AMANDA MARIE SANTIAGO
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Credential | LCPC
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Telephone | 630-534-0658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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