Provider Demographics
NPI:1215534284
Name:OPEN HEARTS CHRISTIAN COUNSELING
Entity Type:Organization
Organization Name:OPEN HEARTS CHRISTIAN COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:FITZGERALD-HOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BED,MDIV,MPA, DAS
Authorized Official - Phone:804-482-6503
Mailing Address - Street 1:2530 CARRIAGE LN APT 1D
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-7925
Mailing Address - Country:US
Mailing Address - Phone:703-593-1061
Mailing Address - Fax:
Practice Address - Street 1:2530 CARRIAGE LN APT 1D
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-7925
Practice Address - Country:US
Practice Address - Phone:703-593-1061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Single Specialty