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General NPI Number Information
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NPI Number | 1942567029
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Entity Type | Organization
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Legal Business Name | LIGHT AND SOUND HEALTH
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 2535 TECHNY RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-5961
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Country | US
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Telephone | 847-291-7020
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Fax | 847-291-7055
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Provider Business Mailing Address
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Address Line | 2535 TECHNY RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-5961
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Country | US
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Telephone | 847-291-7020
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Fax | 847-291-7055
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ALICE C NIXON
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Credential | MSW,LCSW
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Telephone | 847-291-7020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149000231
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License Number State | IL
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