Provider Demographics
NPI:1255786992
Name:HEALING WINGS COUNSELING & CONSULTATION, LLC
Entity type:Organization
Organization Name:HEALING WINGS COUNSELING & CONSULTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FETTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S, NCC
Authorized Official - Phone:740-417-3195
Mailing Address - Street 1:96 W WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2305
Mailing Address - Country:US
Mailing Address - Phone:740-417-3195
Mailing Address - Fax:888-974-3695
Practice Address - Street 1:96 W WILLIAM ST
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2305
Practice Address - Country:US
Practice Address - Phone:740-417-3195
Practice Address - Fax:888-974-3695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-02
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty