Healthcare Provider Details

I. General information

NPI: 1316551583
Provider Name (Legal Business Name): HEALING OPTIONS PROVIDING EMPOWERMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/03/2020
Certification Date: 09/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 RULAND RD
KEARNEYSVILLE WV
25430-2887
US

IV. Provider business mailing address

59 RULAND RD
KEARNEYSVILLE WV
25430-2887
US

V. Phone/Fax

Practice location:
  • Phone: 304-279-5553
  • Fax: 304-606-3096
Mailing address:
  • Phone: 304-279-5553
  • Fax: 304-606-3096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER FITE
Title or Position: THERAPIST
Credential: LICSW
Phone: 304-279-5553