Provider Demographics
NPI:1417638164
Name:HEALING HEARTS COUNSELING
Entity Type:Organization
Organization Name:HEALING HEARTS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:TERESE
Authorized Official - Last Name:KEWAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-441-3263
Mailing Address - Street 1:708 COPPER TREE LN
Mailing Address - Street 2:
Mailing Address - City:WAXHAW
Mailing Address - State:NC
Mailing Address - Zip Code:28173-9967
Mailing Address - Country:US
Mailing Address - Phone:704-441-3263
Mailing Address - Fax:
Practice Address - Street 1:300 S HAYNE ST STE 108
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5505
Practice Address - Country:US
Practice Address - Phone:704-441-3263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)