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General NPI Number Information
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NPI Number | 1780100552
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Entity Type | Organization
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Legal Business Name | HEALING WELL THERAPY
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 01/10/2024
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Provider Practice Location Address
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Address Line | 9325 MIDLOTHIAN TPKE STE B
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4943
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Country | US
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Telephone | 804-304-1831
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Fax |
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Provider Business Mailing Address
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Address Line | 2801 MCRAE RD STE 2C
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-3056
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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 | CEO
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Name | MRS. DENISHA NICOLE SMITH
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Credential | LPC
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Telephone | 804-304-1831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006757
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License Number State | VA
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