Provider Demographics
NPI:1821781683
Name:HEALING HAUS COUNSELING PLLC
Entity Type:Organization
Organization Name:HEALING HAUS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:KEATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LICSW
Authorized Official - Phone:304-620-5512
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25413-0071
Mailing Address - Country:US
Mailing Address - Phone:304-620-5512
Mailing Address - Fax:
Practice Address - Street 1:239 CHIMNEY DR
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:WV
Practice Address - Zip Code:25413-3171
Practice Address - Country:US
Practice Address - Phone:304-620-5512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty