Healthcare Provider Details

I. General information

NPI: 1821781683
Provider Name (Legal Business Name): HEALING HAUS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 CHIMNEY DR
BUNKER HILL WV
25413-3171
US

IV. Provider business mailing address

PO BOX 71
BUNKER HILL WV
25413-0071
US

V. Phone/Fax

Practice location:
  • Phone: 304-620-5512
  • Fax:
Mailing address:
  • Phone: 304-620-5512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JUDITH MARY KEATLEY
Title or Position: OWNER
Credential: MSW LICSW
Phone: 304-620-5512