MEDICARE: HEALING CONNECTIONS 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1457068728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING CONNECTIONS LLC

Provider Business Mailing Address
First Line	:	4529 STOVER ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3261
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4529 STOVER ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-3261
Country	:	US
Telephone Number	:	303-815-3988
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	AMY MOEN
Credential	:
Telephone Number	:	303-815-3988

Provider Enumeration Date	:	11/04/2022
Last Update Date	:	11/04/2022

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Directions to “HEALING CONNECTIONS LLC ” Practice Location

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