MEDICARE: WHOLE HEARTED HEALING, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1679251136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE HEARTED HEALING, LLC

Provider Business Mailing Address
First Line	:	6165 LEHMAN DR STE 102
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-5405
Country	:	US
Telephone Number	:	719-316-8908
Fax Number	:

Provider Business Practice Location Address
First Line	:	6165 LEHMAN DR STE 102
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-5405
Country	:	US
Telephone Number	:	719-377-6192
Fax Number	:	719-496-4536

Authorized Official
Title or Position	:	OWNER
Name	:	MISS AMBER N DUGGER
Credential	:	LCSW
Telephone Number	:	719-377-6192

Provider Enumeration Date	:	07/06/2023
Last Update Date	:	06/30/2025

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Directions to “WHOLE HEARTED HEALING, LLC ” Practice Location

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