Provider Demographics
NPI:1497359194
Name:WHOLEHEARTED HERD COUNSELING, LLC
Entity Type:Organization
Organization Name:WHOLEHEARTED HERD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:CHRISTAL
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:715-200-3838
Mailing Address - Street 1:242031 COUNTY ROAD Y
Mailing Address - Street 2:
Mailing Address - City:ANIWA
Mailing Address - State:WI
Mailing Address - Zip Code:54408-5047
Mailing Address - Country:US
Mailing Address - Phone:715-200-3838
Mailing Address - Fax:715-504-8809
Practice Address - Street 1:242031 COUNTY ROAD Y
Practice Address - Street 2:
Practice Address - City:ANIWA
Practice Address - State:WI
Practice Address - Zip Code:54408-5047
Practice Address - Country:US
Practice Address - Phone:715-200-3838
Practice Address - Fax:715-504-8809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty