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General NPI Number Information
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NPI Number | 1124329388
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Entity Type | Organization
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Legal Business Name | HEALING WATERS COUNSELING CENTER
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 169 SUFFOLK AVE STE 1
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City | RICHLANDS
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State | VA
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Zip | 24641-2434
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Country | US
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Telephone | 276-821-2260
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 426
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City | CEDAR BLUFF
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State | VA
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Zip | 24609-0426
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Country | US
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Telephone | 276-963-0111
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Fax | 276-963-0005
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MR. BRADLEY TODD KINDER
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Credential | M.S., LPC, CSAC
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Telephone | 276-963-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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