Provider Demographics
NPI:1609485580
Name:HEALING-CIRCLE,LLC
Entity Type:Organization
Organization Name:HEALING-CIRCLE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC, NCC
Authorized Official - Phone:312-775-2316
Mailing Address - Street 1:8730 GEORGIA AVE STE 200D
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3651
Mailing Address - Country:US
Mailing Address - Phone:773-569-1827
Mailing Address - Fax:
Practice Address - Street 1:8730 GEORGIA AVE STE 200D
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3651
Practice Address - Country:US
Practice Address - Phone:773-569-1827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING-CIRCLE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty