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NPI 1386469013

NPI 1386469013 : HEALING HOPE SUPERVISION AND EMDR CONSULTATION LLC : MARBLEHEAD, MA

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General NPI Number Information
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    NPI Number           |    1386469013
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    Entity Type          |    Organization 
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    Legal Business Name  |    HEALING HOPE SUPERVISION AND EMDR CONSULTATION LLC 
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Dates
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    Enumeration Date     |    11/18/2024
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    Last Update Date     |    11/18/2024
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Provider Practice Location Address
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    Address Line         |    100 PLEASANT ST UNIT 202 
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    City                 |    MARBLEHEAD
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    State                |    MA
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    Zip                  |    01945-3365
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    Country              |    US
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    Telephone            |    315-247-1589
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    100 PLEASANT ST UNIT 202 
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    City                 |    MARBLEHEAD
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    State                |    MA
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    Zip                  |    01945-3365
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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    |    LICSW, OWNER
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    Name                 |     STEFFANI  POULIOT 
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    Credential           |    
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    Telephone            |    315-247-1589
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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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