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General NPI Number Information
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NPI Number | 1619770070
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Entity Type | Organization
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Legal Business Name | HEARTHSTONE PSYCHOLOGY PLLC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 2950 W CHICAGO AVE STE 202
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City | CHICAGO
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State | IL
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Zip | 60622-4377
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Country | US
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Telephone | 865-806-3802
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Fax |
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Provider Business Mailing Address
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Address Line | 4722 S GREENWOOD AVE APT 3W
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City | CHICAGO
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State | IL
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Zip | 60615-1930
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Country | US
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Telephone | 865-806-3802
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RACHEL SMITH
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Credential | MA, PSYD
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Telephone | 865-806-3802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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