Provider Demographics
NPI:1619730082
Name:HEALING THROUGH CONNECTION
Entity Type:Organization
Organization Name:HEALING THROUGH CONNECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADIA
Authorized Official - Middle Name:VISOLELA
Authorized Official - Last Name:PLOURD
Authorized Official - Suffix:
Authorized Official - Credentials:PSY, D
Authorized Official - Phone:602-935-4084
Mailing Address - Street 1:318 S 116TH AVE
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-1780
Mailing Address - Country:US
Mailing Address - Phone:602-935-4084
Mailing Address - Fax:
Practice Address - Street 1:7155 W CAMPO BELLO DR STE B110
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8594
Practice Address - Country:US
Practice Address - Phone:602-935-4084
Practice Address - Fax:623-218-6230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health