MEDICARE: HEALING ANGELS COLLECTIVE

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1154139152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING ANGELS COLLECTIVE

Provider Business Mailing Address
First Line	:	1244 VIRGINIA BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78203-1834
Country	:	US
Telephone Number	:	210-693-4638
Fax Number	:

Provider Business Practice Location Address
First Line	:	1244 VIRGINIA BLVD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78203-1834
Country	:	US
Telephone Number	:	210-693-4638
Fax Number	:

Authorized Official
Title or Position	:	COUNSELING ASSOCIATE
Name	:	ANGELEAH NEWSOM
Credential	:	LPC
Telephone Number	:	210-920-1950

Provider Enumeration Date	:	12/21/2024
Last Update Date	:	12/21/2024

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Directions to “HEALING ANGELS COLLECTIVE ” Practice Location

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