Provider Demographics
NPI:1598340598
Name:HEALING SELVES THERAPEUTICS, PLLC
Entity Type:Organization
Organization Name:HEALING SELVES THERAPEUTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SCARBORO
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCAS, NCC
Authorized Official - Phone:336-324-8934
Mailing Address - Street 1:PO BOX 58581
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28305-8581
Mailing Address - Country:US
Mailing Address - Phone:336-324-8934
Mailing Address - Fax:
Practice Address - Street 1:1404 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28305-5028
Practice Address - Country:US
Practice Address - Phone:336-324-8934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-11
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty