Healthcare Provider Details

I. General information

NPI: 1437010402
Provider Name (Legal Business Name): THE HEALING PORCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 DELTONA BLVD UNIT 5196
DELTONA FL
32728-7410
US

IV. Provider business mailing address

944 DELTONA BLVD UNIT 5196
DELTONA FL
32728-7410
US

V. Phone/Fax

Practice location:
  • Phone: 386-272-2913
  • Fax:
Mailing address:
  • Phone: 407-853-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: ALICIA CREWS
Title or Position: OWNER
Credential: PMHNP
Phone: 386-272-2913