MEDICARE: HEALING YOUR HEART AND MIND, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1962109868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING YOUR HEART AND MIND, LLC

Provider Business Mailing Address
First Line	:	527 LAMBOURNE CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-0627
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8501 W UNIVERSITY AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6157
Country	:	US
Telephone Number	:	702-483-1298
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	MRS. RUTH MOHAMED
Credential	:	LCSW
Telephone Number	:	702-483-1298

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	02/11/2023

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Directions to “HEALING YOUR HEART AND MIND, LLC ” Practice Location

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