MEDICARE: HEALING FALLS COUNSELING PLLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1154156578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING FALLS COUNSELING PLLC

Provider Business Mailing Address
First Line	:	2440 COMMERCE RD STE 225
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7563
Country	:	US
Telephone Number	:	910-518-8777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2440 COMMERCE RD STE 225
Second Line	:
City	:	JACKSONVILLE
State	:	NC
Zip	:	28546-7563
Country	:	US
Telephone Number	:	910-518-8777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LYDIA KERNS
Credential	:	THERAPIST
Telephone Number	:	910-518-8777

Provider Enumeration Date	:	09/05/2024
Last Update Date	:	03/08/2025

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