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General NPI Number Information
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NPI Number | 1922670405
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Entity Type | Organization
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Legal Business Name | HEALING TO GROW COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/14/2021
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 300 EAST ST N STE B
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City | TALLADEGA
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State | AL
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Zip | 35160-2074
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Country | US
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Telephone | 256-240-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 1202 HABITAT LN
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City | ANNISTON
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State | AL
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Zip | 36201-6564
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Country | US
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Telephone | 256-240-1777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEY JUDKINS
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Credential | LPC,NCC
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Telephone | 256-240-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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