Provider Demographics
NPI:1902217102
Name:WHOLEHEARTED COUNSELING PLLC
Entity Type:Organization
Organization Name:WHOLEHEARTED COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:FAILONI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-751-9015
Mailing Address - Street 1:15608 N 71ST ST
Mailing Address - Street 2:#116
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5359
Mailing Address - Country:US
Mailing Address - Phone:480-751-9015
Mailing Address - Fax:
Practice Address - Street 1:7901 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5510
Practice Address - Country:US
Practice Address - Phone:480-751-9015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-11
Last Update Date:2014-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13401101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty