Provider Demographics
NPI:1790555001
Name:TALK YOUR HEART OUT LLC
Entity Type:Organization
Organization Name:TALK YOUR HEART OUT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:POONAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-595-9342
Mailing Address - Street 1:535 BROOKWOOD POINT PL APT 1023
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-6923
Mailing Address - Country:US
Mailing Address - Phone:256-595-9342
Mailing Address - Fax:
Practice Address - Street 1:535 BROOKWOOD POINT PL APT 1023
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-6923
Practice Address - Country:US
Practice Address - Phone:256-595-9342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty