Provider Demographics
NPI:1821610304
Name:HEALTHY CONNECTIONS COUNSELING, LLC
Entity Type:Organization
Organization Name:HEALTHY CONNECTIONS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:971-719-8864
Mailing Address - Street 1:400 GLEN CREEK RD NW UNIT 6112
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-0496
Mailing Address - Country:US
Mailing Address - Phone:503-507-3649
Mailing Address - Fax:855-393-8099
Practice Address - Street 1:2640 PORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-0125
Practice Address - Country:US
Practice Address - Phone:503-507-3549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty