Healthcare Provider Details

I. General information

NPI: 1932939915
Provider Name (Legal Business Name): HEALING HEARTS COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2024
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 E BROAD ST STE 210
RICHMOND VA
23219-1737
US

IV. Provider business mailing address

1704 ROSE AVE
RICHMOND VA
23222-4927
US

V. Phone/Fax

Practice location:
  • Phone: 804-874-3208
  • Fax:
Mailing address:
  • Phone: 804-874-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAMITA PERRY
Title or Position: CEO
Credential:
Phone: 804-874-3208