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General NPI Number Information
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NPI Number | 1124819990
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Entity Type | Organization
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Legal Business Name | WHOLEHEARTED THERAPY LLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 351 RADIO PARK DR STE 202
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City | RICHMOND
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State | KY
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Zip | 40475-2668
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Country | US
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Telephone | 502-501-7381
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Fax |
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Provider Business Mailing Address
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Address Line | 34 VIRGINIA AVE
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City | WINCHESTER
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State | KY
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Zip | 40391-1120
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HEATHER NICOLE BRANDENBURG
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Credential | LCSW
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Telephone | 859-644-9033
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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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