Healthcare Provider Details

I. General information

NPI: 1144014648
Provider Name (Legal Business Name): HEALING INTENTIONALLY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 HARD ROCK LN
GAINESVILLE MO
65655-7801
US

IV. Provider business mailing address

PO BOX 116
GAINESVILLE MO
65655-0116
US

V. Phone/Fax

Practice location:
  • Phone: 575-649-1981
  • Fax:
Mailing address:
  • Phone:
  • 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: TAMARA DEES
Title or Position: OWNER/LCSW
Credential: LCSW
Phone: 575-649-1981