Healthcare Provider Details

I. General information

NPI: 1083491260
Provider Name (Legal Business Name): HEALING HEARTS FAMILY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 N 3RD ST STE 203
HANNIBAL MO
63401-3518
US

IV. Provider business mailing address

108 N 3RD ST STE 203
HANNIBAL MO
63401-3518
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: NAKITA ANN HUGHES
Title or Position: OWNER, THERAPIST
Credential: MA, LPC, LMFT
Phone: 573-822-2636