Healthcare Provider Details

I. General information

NPI: 1932064367
Provider Name (Legal Business Name): MA HEALING THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 ROUTE 111 # 333
HAUPPAUGE NY
11788-4346
US

IV. Provider business mailing address

530 ROUTE 111 # 333
HAUPPAUGE NY
11788-4346
US

V. Phone/Fax

Practice location:
  • Phone: 631-686-4418
  • Fax:
Mailing address:
  • Phone: 631-686-4418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MIRIAM CHAVELY ARTHUR
Title or Position: CLINICAL SOCIAL WORKER
Credential: LCSW, IMH-DP, IMH-E
Phone: 631-686-4418