MEDICARE: HEALING AND EMPOWERMENT COUNSELING CENTER

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1699364000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING AND EMPOWERMENT COUNSELING CENTER

Provider Business Mailing Address
First Line	:	4452 HIGHLAND AVE APT 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4345
Country	:	US
Telephone Number	:	619-399-6644
Fax Number	:

Provider Business Practice Location Address
First Line	:	4452 HIGHLAND AVE APT 1
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-4345
Country	:	US
Telephone Number	:	619-399-6644
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TERI ASHLEY DUNBAR
Credential	:
Telephone Number	:	619-399-6644

Provider Enumeration Date	:	01/12/2021
Last Update Date	:	01/12/2021

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