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General NPI Number Information
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NPI Number | 1396479556
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Entity Type | Organization
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Legal Business Name | HEALING HEARTS TRAUMA THERAPY LLC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1027 S VANDEVENTER AVE STE 618
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City | SAINT LOUIS
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State | MO
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Zip | 63110-3800
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Country | US
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Telephone | 772-773-0065
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Fax | 949-655-5979
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Provider Business Mailing Address
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Address Line | 10922 SCHUETZ RD
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City | SAINT LOUIS
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State | MO
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Zip | 63146-5704
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Country | US
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Telephone | 772-773-0065
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Fax | 949-655-5979
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Authorized Official
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Title or Position | OWNER
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Name | SHARNITA WHITE
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Credential | LMHC
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Telephone | 813-557-4701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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