MEDICARE: HEALING HEARTS FAMILY COUNSELING LLC

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	106H00000X	Marriage & Family Therapist
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1083491260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HEARTS FAMILY COUNSELING LLC

Provider Business Mailing Address
First Line	:	108 N 3RD ST STE 203
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-3518
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 N 3RD ST STE 203
Second Line	:
City	:	HANNIBAL
State	:	MO
Zip	:	63401-3518
Country	:	US
Telephone Number	:
Fax Number	:

Authorized Official
Title or Position	:	OWNER, THERAPIST
Name	:	NAKITA ANN HUGHES
Credential	:	MA, LPC, LMFT
Telephone Number	:	573-822-2636

Provider Enumeration Date	:	09/12/2023
Last Update Date	:	09/12/2023

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