Provider Demographics
NPI:1174180798
Name:HEALTHY HABITS COACHING LLC
Entity Type:Organization
Organization Name:HEALTHY HABITS COACHING LLC
Other - Org Name:A POSITIVE LIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC, LPC-QMHP
Authorized Official - Phone:605-484-9294
Mailing Address - Street 1:2810 W FLORMANN ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-4233
Mailing Address - Country:US
Mailing Address - Phone:605-484-9294
Mailing Address - Fax:605-415-4418
Practice Address - Street 1:2810 W FLORMANN ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-4233
Practice Address - Country:US
Practice Address - Phone:605-484-9294
Practice Address - Fax:605-415-4418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-20
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty