MEDICARE: HEALING SPACE COUNSELING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1679315535
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING SPACE COUNSELING SERVICES, LLC

Provider Business Mailing Address
First Line	:	4963 N MULLIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2962
Country	:	US
Telephone Number	:	312-451-1110
Fax Number	:

Provider Business Practice Location Address
First Line	:	4963 N MULLIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2962
Country	:	US
Telephone Number	:	312-451-1110
Fax Number	:

Authorized Official
Title or Position	:	BILLER
Name	:	MRS. VANESSA GALVAN
Credential	:	CMRS
Telephone Number	:	832-528-6481

Provider Enumeration Date	:	06/11/2024
Last Update Date	:	06/11/2024

Similar Medicare Providers

1154497253 — EDWARD N TUDER MD SC
Practice Location Address:

150 E HURON ST , STE 1306
CHICAGO, IL
60611-2962

Practice Phone: 312-943-0378
Practice Fax: 312-943-9943

1144438425 — VICTOR C. NEUMANN ASSOCIATION
Practice Location Address:

4016 N BELL AVE
CHICAGO, IL
60618-2962

Practice Phone: 773-478-4310
Practice Fax:

1093989170 — EDWARD TUDER MD
Practice Location Address:

150 E HURON STREET , SUITE 1306
CHICAGO, IL
60611-2962

Practice Phone: 312-943-0378
Practice Fax: 312-943-9943

1518810084 — DOMINIQUE GRAY
Practice Location Address:

4839 N ELSTON AVE
CHICAGO, IL
60630-2534

Practice Phone: 866-727-8274
Practice Fax:

1194676734 — MORGAN SALHANEY RBT
Practice Location Address:

4908 N ELSTON AVE
CHICAGO, IL
60630-2506

Practice Phone: 773-205-8505
Practice Fax:

1144171679 — SHEILA LOPEZ
Practice Location Address:

4839 N ELSTON AVE
CHICAGO, IL
60630-2534

Practice Phone: 866-727-8274
Practice Fax:

Directions to “HEALING SPACE COUNSELING SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.