Provider Demographics
NPI:1114562543
Name:HEALING HORIZONS PROFESSIONAL COUNSELING LLC
Entity Type:Organization
Organization Name:HEALING HORIZONS PROFESSIONAL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPCC
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS,LPCC, NCC
Authorized Official - Phone:740-641-5020
Mailing Address - Street 1:4548 KELLER RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025-9404
Mailing Address - Country:US
Mailing Address - Phone:740-641-5020
Mailing Address - Fax:
Practice Address - Street 1:927 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:OH
Practice Address - Zip Code:43023
Practice Address - Country:US
Practice Address - Phone:740-641-5020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0295672Medicaid