Provider Demographics
NPI:1336767722
Name:HEALING WITH PLAY, INC
Entity Type:Organization
Organization Name:HEALING WITH PLAY, INC
Other - Org Name:HEALING WITH PLAY COUNSELING & TRAINING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGEST
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:561-473-4219
Mailing Address - Street 1:12300 S SHORE BLVD STE 222
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6509
Mailing Address - Country:US
Mailing Address - Phone:561-473-4219
Mailing Address - Fax:
Practice Address - Street 1:12300 S SHORE BLVD STE 222
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6509
Practice Address - Country:US
Practice Address - Phone:561-473-4219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-11
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty