Provider Demographics
NPI:1760973200
Name:HEALING IN THE HOME COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:HEALING IN THE HOME COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GLADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-729-4635
Mailing Address - Street 1:114 NE 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-3125
Mailing Address - Country:US
Mailing Address - Phone:561-729-4635
Mailing Address - Fax:561-717-0471
Practice Address - Street 1:1825 NW CORPORATE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8554
Practice Address - Country:US
Practice Address - Phone:561-717-0470
Practice Address - Fax:561-717-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW113181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty