Provider Demographics
NPI:1760846174
Name:HEARTSPHERE COUNSELING, LLC
Entity Type:Organization
Organization Name:HEARTSPHERE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PRESTE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:219-779-7817
Mailing Address - Street 1:9495 KEILMAN ST
Mailing Address - Street 2:SUITE 6A
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-8924
Mailing Address - Country:US
Mailing Address - Phone:219-779-7817
Mailing Address - Fax:
Practice Address - Street 1:9495 KEILMAN ST
Practice Address - Street 2:SUITE 6A
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-8924
Practice Address - Country:US
Practice Address - Phone:219-779-7817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002846A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health