Provider Demographics
NPI:1689360356
Name:HEALING PATH THERAPY P.C.
Entity Type:Organization
Organization Name:HEALING PATH THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHANDA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BOYDEN-DEIDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LISW
Authorized Official - Phone:317-316-9733
Mailing Address - Street 1:1731 E COUNTY ROAD 600 N
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:IN
Mailing Address - Zip Code:46167-9011
Mailing Address - Country:US
Mailing Address - Phone:317-938-8517
Mailing Address - Fax:
Practice Address - Street 1:1731 E COUNTY ROAD 600 N
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:IN
Practice Address - Zip Code:46167-9011
Practice Address - Country:US
Practice Address - Phone:317-316-9733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty