Provider Demographics
NPI:1407501331
Name:HEARTS 2 HEAL, LLC
Entity Type:Organization
Organization Name:HEARTS 2 HEAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KIONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-914-8615
Mailing Address - Street 1:4132 E JOPPA RD STE 110-834
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2272
Mailing Address - Country:US
Mailing Address - Phone:410-914-8615
Mailing Address - Fax:
Practice Address - Street 1:4132 E JOPPA RD STE 110-834
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-2272
Practice Address - Country:US
Practice Address - Phone:410-914-8615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty