Provider Demographics
NPI:1538647045
Name:ONE BREATH HEALING LLC
Entity Type:Organization
Organization Name:ONE BREATH HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHERVEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:818-585-2760
Mailing Address - Street 1:19175 N 95TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5573
Mailing Address - Country:US
Mailing Address - Phone:818-588-6275
Mailing Address - Fax:
Practice Address - Street 1:19175 N 95TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5573
Practice Address - Country:US
Practice Address - Phone:818-585-2760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA53680OtherMARRIAGE AND FAMILY THERAPY LICENSE
AZLMFT-15266OtherMARRIAGE AND FAMILY THERAPY LICENSE