Provider Demographics
NPI:1467178129
Name:HEALING SPACES COUNSELING, LLC
Entity Type:Organization
Organization Name:HEALING SPACES COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ISABELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:STACKL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:301-357-2727
Mailing Address - Street 1:11715 KING TREE ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2636
Mailing Address - Country:US
Mailing Address - Phone:301-357-2727
Mailing Address - Fax:
Practice Address - Street 1:11715 KING TREE ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-2636
Practice Address - Country:US
Practice Address - Phone:301-357-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty