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General NPI Number Information
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NPI Number | 1952290439
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Entity Type | Organization
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Legal Business Name | NOMADIC HEART THERAPY, LLC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 6650 RIVERS AVE STE 100
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4809
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Country | US
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Telephone | 301-673-1947
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 E ROCK WREN RD
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City | PHOENIX
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State | AZ
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Zip | 85044-6766
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Country | US
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Telephone | 240-434-3014
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | ASHLEY FAUCETTE
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Credential | LCSW-C
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Telephone | 240-434-3014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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