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General NPI Number Information
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NPI Number | 1831829993
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Entity Type | Organization
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Legal Business Name | WHOLEHEART COUNSELING SERVICES PLLC
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 1200 S MAIN ST STE 218
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City | WEATHERFORD
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State | TX
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Zip | 76086-5987
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Country | US
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Telephone | 940-859-0108
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 OLIVER ST
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City | WEATHERFORD
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State | TX
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Zip | 76086-1525
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Country | US
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Telephone | 817-614-5788
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | CHARLENA D PRIDDY
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Credential | MS, LPC
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Telephone | 817-614-5788
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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 |
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License Number State |
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Taxonomy #2
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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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