Provider Demographics
NPI:1902395478
Name:HEALING HARBOR THERAPY GROUP
Entity Type:Organization
Organization Name:HEALING HARBOR THERAPY GROUP
Other - Org Name:HEALING HARBOR THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:360-334-7370
Mailing Address - Street 1:PO BOX 445
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-0445
Mailing Address - Country:US
Mailing Address - Phone:360-334-7370
Mailing Address - Fax:360-404-3946
Practice Address - Street 1:2076 MAIN ST UNIT 4
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9468
Practice Address - Country:US
Practice Address - Phone:360-664-7370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty