Healthcare Provider Details

I. General information

NPI: 1275479693
Provider Name (Legal Business Name): THE HEALING HOLLER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 PIEDMONT CT
MASCOTTE FL
34753-9501
US

IV. Provider business mailing address

1960 PIEDMONT CT
MASCOTTE FL
34753-9501
US

V. Phone/Fax

Practice location:
  • Phone: 407-401-2917
  • Fax:
Mailing address:
  • Phone: 407-401-2917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: BETTY L SANGLE
Title or Position: OWNER/ PROVIDER
Credential: LMHC
Phone: 407-401-2917