MEDICARE: HEALING HEARTS COUNSELING CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	C.0500279	OH

General Provider Information

NPI Number	:	1003111675
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HEARTS COUNSELING CENTER

Provider Business Mailing Address
First Line	:	680 PARK AVE W
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3706
Country	:	US
Telephone Number	:	419-528-5993
Fax Number	:	646-365-2786

Provider Business Practice Location Address
First Line	:	680 PARK AVE W
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3706
Country	:	US
Telephone Number	:	419-528-5993
Fax Number	:	646-365-2786

Authorized Official
Title or Position	:	OWNER
Name	:	MAJA-LISA ANDERSON
Credential	:	LPCC
Telephone Number	:	419-564-8767

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	10/28/2024

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