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General NPI Number Information
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NPI Number | 1598340598
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Entity Type | Organization
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Legal Business Name | HEALING SELVES THERAPEUTICS, PLLC
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 1404 RAEFORD RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5028
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Country | US
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Telephone | 336-324-8934
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 58581
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-8581
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Country | US
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Telephone | 336-324-8934
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | HEATHER MICHELLE SCARBORO
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Credential | LCMHC, LCAS, NCC
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Telephone | 336-324-8934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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