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General NPI Number Information
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NPI Number | 1568282325
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Entity Type | Organization
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Legal Business Name | ESSENTIAL HEALING LLC
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 52 PARK MEADOW DR
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City | WEST SENECA
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State | NY
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Zip | 14224-3868
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Country | US
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Telephone | 716-472-6673
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Fax |
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Provider Business Mailing Address
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Address Line | 52 PARK MEADOW DR
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City | WEST SENECA
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State | NY
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Zip | 14224-3868
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Country | US
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Telephone | 716-472-6673
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | ESSENCE PORTER-MCDOWELL
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Credential | LCSW
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Telephone | 716-472-6673
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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