Healthcare Provider Details

I. General information

NPI: 1346947520
Provider Name (Legal Business Name): HEALING AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2023
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 STERLING ST
PLAINFIELD NJ
07062-2236
US

IV. Provider business mailing address

275 SOUTH AVE UNIT 121
FANWOOD NJ
07023-6607
US

V. Phone/Fax

Practice location:
  • Phone: 914-434-0317
  • Fax:
Mailing address:
  • Phone: 914-434-0317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: ENID BURTON
Title or Position: SOCIAL WORKER
Credential: LCSW
Phone: 914-434-0317