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NPI Code Detail

MEDICARE: RADIANT HEART THERAPY PROFESSIONAL LIMITED LIABILITY COMPANY

MEDICARE: RADIANT HEART THERAPY PROFESSIONAL LIMITED LIABILITY COMPANY
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
1101YM0800XMental Health Counselor
2101YA0400XAddiction (Substance Use Disorder) Counselor
3106H00000XMarriage & Family Therapist
4101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1275347395
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIANT HEART THERAPY PROFESSIONAL LIMITED LIABILITY COMPANY
Provider Business Mailing Address
First Line : 514 COUNTY ROAD 2730
Second Line :
City : DECATUR
State : TX
Zip : 76234-7518
Country : US
Telephone Number : 818-618-3619
Fax Number :
Provider Business Practice Location Address
First Line : 5000 THAYER CTR
Second Line :
City : OAKLAND
State : MD
Zip : 21550-1139
Country : US
Telephone Number : 818-618-3619
Fax Number :
Authorized Official
Title or Position : LPC/CEO/OWNER
Name : SAHARA ELIZABETH BUNNA
Credential : MA, MFT, LPC, NCC
Telephone Number : 818-618-3619
Provider Enumeration Date : 02/07/2025
Last Update Date : 02/13/2026

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