Provider Demographics
NPI:1689752933
Name:HEALING HEARTS OF TENNESSEE, INC.
Entity Type:Organization
Organization Name:HEALING HEARTS OF TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:VINES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:931-474-4673
Mailing Address - Street 1:107 E MORFORD ST
Mailing Address - Street 2:
Mailing Address - City:MC MINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-2521
Mailing Address - Country:US
Mailing Address - Phone:931-474-4673
Mailing Address - Fax:931-494-4674
Practice Address - Street 1:107 E MORFORD ST
Practice Address - Street 2:
Practice Address - City:MC MINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2521
Practice Address - Country:US
Practice Address - Phone:931-474-4673
Practice Address - Fax:931-494-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLCSW000000070471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty