Provider Demographics
NPI:1588197578
Name:HEALING INTO WHOLENESS
Entity Type:Organization
Organization Name:HEALING INTO WHOLENESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPY
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:443-824-0577
Mailing Address - Street 1:142 GEORGETOWN RD
Mailing Address - Street 2:SUITE 12
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-3498
Mailing Address - Country:US
Mailing Address - Phone:410-267-0552
Mailing Address - Fax:
Practice Address - Street 1:49 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3854
Practice Address - Country:US
Practice Address - Phone:443-824-0577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty