MEDICARE: THE HEALING CENTER - BODY, MIND, SPIRIT

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1710542105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALING CENTER - BODY, MIND, SPIRIT

Provider Business Mailing Address
First Line	:	2915 ASTOR AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43209-2626
Country	:	US
Telephone Number	:	740-438-4495
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 E MAIN ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-5369
Country	:	US
Telephone Number	:	740-438-4495
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MS. RACHAEL GARDNER PURDY
Credential	:	LICDC, LSW, LPC
Telephone Number	:	740-438-4495

Provider Enumeration Date	:	05/01/2019
Last Update Date	:	05/01/2019

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