Provider Demographics
NPI:1275901407
Name:HEALING WITH WISDOM, LLC
Entity Type:Organization
Organization Name:HEALING WITH WISDOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERRI-ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-508-4705
Mailing Address - Street 1:3956 TOWN CTR BLVD
Mailing Address - Street 2:SUITE 22
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6103
Mailing Address - Country:US
Mailing Address - Phone:407-508-4705
Mailing Address - Fax:407-264-6726
Practice Address - Street 1:3956 TOWN CTR BLVD
Practice Address - Street 2:SUITE 22
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6103
Practice Address - Country:US
Practice Address - Phone:407-508-4705
Practice Address - Fax:407-264-6726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
FLMH10070251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management