Provider Demographics
NPI:1982043840
Name:HEALING COUNSELING
Entity Type:Organization
Organization Name:HEALING COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC/CAP
Authorized Official - Phone:813-416-5458
Mailing Address - Street 1:10400 SW STEPHANIE WAY APT 207
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34987-1974
Mailing Address - Country:US
Mailing Address - Phone:813-416-5458
Mailing Address - Fax:772-237-7726
Practice Address - Street 1:10400 SW STEPHANIE WAY APT 207
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34987-1974
Practice Address - Country:US
Practice Address - Phone:813-416-5458
Practice Address - Fax:772-237-7726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9670101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty