Healthcare Provider Details

I. General information

NPI: 1992442859
Provider Name (Legal Business Name): HEALING HANDS INTEGRATED WELLNESS & PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

878 FOX DR
WINCHESTER VA
22603-8613
US

IV. Provider business mailing address

878 FOX DR
WINCHESTER VA
22603-8613
US

V. Phone/Fax

Practice location:
  • Phone: 540-546-2624
  • Fax: 540-696-5421
Mailing address:
  • Phone: 540-546-2624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MELAINA KUZEMKA KUPKA
Title or Position: OFFICE MANAGER
Credential:
Phone: 540-546-2624