HEALING HEARTS THERAPEUTIC SERVICES INC NPI 1053498683

NPI Information

NPI: 1053498683
Provider Name: HEALING HEARTS THERAPEUTIC SERVICES, INC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
824 GUM BRANCH RD STE E
JACKSONVILLE, NC
ZIP 28540
Phone: (910) 347-1694
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HEALING HEARTS THERAPEUTIC SERVICES, INC is an addiction (substance use disorder) counselor in Jacksonville, NC. HEALING HEARTS THERAPEUTIC SERVICES, INC NPI is 1053498683. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

824 GUM BRANCH RD STE E
JACKSONVILLE, NC
ZIP 28540-269
Phone: (910) 347-1694
Fax: (910) 347-3691

The provider's authorized official is Demetrious Shepard .
The authorized official title is Ceo Clinical Director and has the following contact phone number (910) 347-1694.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 7/20/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional			No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6005845	MEDICAID	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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