Provider Demographics
NPI:1417366527
Name:THE HEALING WATERS COUNSELING WELLNESS CONSULTING & TRAINING CENTER
Entity Type:Organization
Organization Name:THE HEALING WATERS COUNSELING WELLNESS CONSULTING & TRAINING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CORNELIA
Authorized Official - Middle Name:AIDA
Authorized Official - Last Name:BROWNING-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-344-2294
Mailing Address - Street 1:867 WEYANOKE LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23608-9311
Mailing Address - Country:US
Mailing Address - Phone:757-344-2294
Mailing Address - Fax:
Practice Address - Street 1:809 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-1090
Practice Address - Country:US
Practice Address - Phone:757-344-2294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904003893251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health