Provider Demographics
NPI:1306185251
Name:HEART TO HEART OUTREACH MINISTRIES, INC.
Entity Type:Organization
Organization Name:HEART TO HEART OUTREACH MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:BS, BCPC, LMFC
Authorized Official - Phone:228-218-6795
Mailing Address - Street 1:PO BOX 10497
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39505-0497
Mailing Address - Country:US
Mailing Address - Phone:228-265-1535
Mailing Address - Fax:
Practice Address - Street 1:131 LEE ANDERSON RD
Practice Address - Street 2:
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-8400
Practice Address - Country:US
Practice Address - Phone:228-265-1535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSSA708302101YP1600X, 106H00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty