Healthcare Provider Details

I. General information

NPI: 1396437216
Provider Name (Legal Business Name): HEALING HEARTS CARROLL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2023
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 ENGLAR RD STE 10
WESTMINSTER MD
21157-2927
US

IV. Provider business mailing address

629 MARPETE DR
HAMPSTEAD MD
21074-1740
US

V. Phone/Fax

Practice location:
  • Phone: 410-294-9612
  • Fax:
Mailing address:
  • Phone: 410-294-9612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURA COULTER
Title or Position: OWNER/PRACTICINER
Credential: LCSW-C
Phone: 410-294-9612