Healthcare Provider Details

I. General information

NPI: 1477460541
Provider Name (Legal Business Name): HEALING CONNECTIONS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 TIPPERARY TRL
FORT WAYNE IN
46815-8146
US

IV. Provider business mailing address

7801 TIPPERARY TRL
FORT WAYNE IN
46815-8146
US

V. Phone/Fax

Practice location:
  • Phone: 260-209-4575
  • Fax:
Mailing address:
  • Phone: 260-209-4575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RYLIE E COOK
Title or Position: MANAGER/ THERAPIST
Credential: LCSW
Phone: 260-209-4575