Provider Demographics
NPI:1619006285
Name:HEART TO HEART CHRISTIAN COUNSELING LLC
Entity Type:Organization
Organization Name:HEART TO HEART CHRISTIAN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official - Prefix:DR
Authorized Official - First Name:VEARL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:GALVIN DELSOL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD LCPC
Authorized Official - Phone:417-893-9298
Mailing Address - Street 1:6951 VIRGINIA PKWY
Mailing Address - Street 2:SUITE 318
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5713
Mailing Address - Country:US
Mailing Address - Phone:417-893-9298
Mailing Address - Fax:
Practice Address - Street 1:6951 VIRGINIA PKWY
Practice Address - Street 2:318
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5713
Practice Address - Country:US
Practice Address - Phone:417-893-9298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005826101Y00000X
IL180-005826101YM0800X, 101YP1600X, 101YP2500X, 101YS0200X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL323486553001Medicaid