Provider Demographics
NPI:1093340044
Name:HEARTFUL HEALING LLC
Entity Type:Organization
Organization Name:HEARTFUL HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-938-4174
Mailing Address - Street 1:3411 W DIVERSEY AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-1281
Mailing Address - Country:US
Mailing Address - Phone:847-447-6953
Mailing Address - Fax:
Practice Address - Street 1:3411 W DIVERSEY AVE STE 8
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-1281
Practice Address - Country:US
Practice Address - Phone:847-447-6953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health