Healthcare Provider Details
I. General information
NPI: 1447028709
Provider Name (Legal Business Name): ENLIGHTENED HEARTS PSYCHOTHERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2023
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 THE GRN STE B
DOVER DE
19901-3618
US
IV. Provider business mailing address
PO BOX 35
MAGNOLIA DE
19962-0035
US
V. Phone/Fax
- Phone: 914-440-0772
- Fax:
- Phone: 914-440-0772
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
PICHE
Title or Position: OWNER
Credential: LCSW
Phone: 914-440-0772