Provider Demographics
NPI:1548032808
Name:IMPERCEPTIBLE HEALING PLLC
Entity type:Organization
Organization Name:IMPERCEPTIBLE HEALING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:JA'NET
Authorized Official - Last Name:FOOTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-802-2442
Mailing Address - Street 1:515 CASS ST
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:IL
Mailing Address - Zip Code:60417-2820
Mailing Address - Country:US
Mailing Address - Phone:312-802-2442
Mailing Address - Fax:
Practice Address - Street 1:288 MAIN ST
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-2098
Practice Address - Country:US
Practice Address - Phone:312-802-2442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty