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General NPI Number Information
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NPI Number | 1710867981
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Entity Type | Organization
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Legal Business Name | HEALING WATERS MENTAL HEALTH LLC
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1706 TRIANGLE PARK DR
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City | MARYVILLE
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State | TN
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Zip | 37801-3749
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Country | US
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Telephone | 865-214-7343
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Fax | 865-381-1437
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Provider Business Mailing Address
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Address Line | 1706 TRIANGLE PARK DR
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City | MARYVILLE
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State | TN
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Zip | 37801-3749
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Country | US
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Telephone | 865-214-7343
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Fax | 865-381-1437
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Authorized Official
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Title or Position | OWNER, PROVIDER
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Name | SUZANNE MARIE WINZENBURG
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Credential | PHMNP-BC, FNP-BC
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Telephone | 865-214-7343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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