Healthcare Provider Details

I. General information

NPI: 1114509056
Provider Name (Legal Business Name): HEALING CONTINUALLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4613 W ORANGE AVE
COOLIDGE AZ
85128-8250
US

IV. Provider business mailing address

2538 E UNIVERSITY DR STE 280
PHOENIX AZ
85034-6947
US

V. Phone/Fax

Practice location:
  • Phone: 214-335-9784
  • Fax:
Mailing address:
  • Phone: 214-335-9784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SOPHIE GWELO
Title or Position: NURSE PRACTITIONER
Credential: PMHNP-BC MSN
Phone: 214-335-9784