Healthcare Provider Details

I. General information

NPI: 1396466272
Provider Name (Legal Business Name): HEALTHY HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 LEE RD STE 219
CLEVELAND HEIGHTS OH
44118-2559
US

IV. Provider business mailing address

2000 LEE RD STE 219
CLEVELAND HEIGHTS OH
44118-2559
US

V. Phone/Fax

Practice location:
  • Phone: 216-446-5117
  • Fax: 216-516-0558
Mailing address:
  • Phone: 216-446-5117
  • Fax: 216-516-0558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NICOLE DENISE NICKENS
Title or Position: CEO
Credential: NP
Phone: 216-315-3980