Provider Demographics
NPI:1700405727
Name:THE CENTER FOR HEALING CONVERSATIONS, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR HEALING CONVERSATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-365-4664
Mailing Address - Street 1:1608 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6208
Mailing Address - Country:US
Mailing Address - Phone:302-365-4664
Mailing Address - Fax:302-543-5097
Practice Address - Street 1:1608 NEWPORT GAP PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-6208
Practice Address - Country:US
Practice Address - Phone:302-365-4664
Practice Address - Fax:302-543-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1932452216Medicaid
DEPC-0000600OtherPROFESSIONAL LICENSE