Healthcare Provider Details

I. General information

NPI: 1497275531
Provider Name (Legal Business Name): HEALING HANDS HOMECARE AND SOUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10439 GARDO CT
SAINT LOUIS MO
63137-3507
US

IV. Provider business mailing address

10439 GARDO CT
SAINT LOUIS MO
63137-3507
US

V. Phone/Fax

Practice location:
  • Phone: 314-813-4458
  • Fax: 314-736-6988
Mailing address:
  • Phone: 314-813-4458
  • Fax: 314-736-6988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateMO

VIII. Authorized Official

Name: MRS. IVORIE D CHAMBERS
Title or Position: OWNER
Credential: LPC
Phone: 314-813-4458