Provider Demographics
NPI:1033751953
Name:WARRIORHEART HEALLING HEARTS LLC
Entity Type:Organization
Organization Name:WARRIORHEART HEALLING HEARTS LLC
Other - Org Name:NEW VISION
Other - Org Type:Other Name
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-623-4075
Mailing Address - Street 1:10316 CAROLYN DR
Mailing Address - Street 2:
Mailing Address - City:NEWALLA
Mailing Address - State:OK
Mailing Address - Zip Code:74857-7605
Mailing Address - Country:US
Mailing Address - Phone:405-623-4075
Mailing Address - Fax:
Practice Address - Street 1:11209 N MAY AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6351
Practice Address - Country:US
Practice Address - Phone:405-623-4075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-11
Last Update Date:2019-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty