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General NPI Number Information
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NPI Number | 1639892375
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Entity Type | Organization
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Legal Business Name | THE HEALING SPOT LLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 15124 BARNES EDGE CT
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City | WOODBRIDGE
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State | VA
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Zip | 22193-3189
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Country | US
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Telephone | 703-574-6014
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Fax |
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Provider Business Mailing Address
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Address Line | 14497 POTOMAC MILLS RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-6807
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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 | COURTNEY WILLIAMS
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Credential | LCSW
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Telephone | 706-563-7231
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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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