Healthcare Provider Details

I. General information

NPI: 1497435192
Provider Name (Legal Business Name): HEARTFELT INTERVENTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6023 MARKET ST
PHILADELPHIA PA
19139-3880
US

IV. Provider business mailing address

1500 CHESTNUT ST STE 2 #1020
PHILADELPHIA PA
19102-2700
US

V. Phone/Fax

Practice location:
  • Phone: 215-834-3773
  • Fax:
Mailing address:
  • Phone: 215-834-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KAREEMA ABDUSSALAAM
Title or Position: OWNER
Credential: LCSW
Phone: 215-834-3773