Healthcare Provider Details

I. General information

NPI: 1457826141
Provider Name (Legal Business Name): HEALING HEARTS WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 10/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

967 E SWEDESFORD RD
EXTON PA
19341-2332
US

IV. Provider business mailing address

1116 OVERLOOK DR
COATESVILLE PA
19320-4822
US

V. Phone/Fax

Practice location:
  • Phone: 610-790-3442
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
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: KANJANA M HARTSHORNE
Title or Position: PSYCHOTHERAPIST AND YOGA THERAPIST
Credential: LCSW, C-IAYT
Phone: 610-790-3442