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General NPI Number Information
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NPI Number | 1811492911
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Entity Type | Organization
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Legal Business Name | HEALING ELEMENTS LLC
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 6494 SW 60TH ST
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City | AUGUSTA
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State | KS
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Zip | 67010-7790
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Country | US
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Telephone | 316-644-2924
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Fax |
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Provider Business Mailing Address
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Address Line | 6494 SW 60TH ST
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City | AUGUSTA
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State | KS
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Zip | 67010-7790
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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 | LCMFT
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Name | BREANNA BURNS
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Credential | LCMFT
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Telephone | 316-644-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2765
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License Number State | KS
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