Provider Demographics
NPI:1740010842
Name:HEALING WITH HEART LLC
Entity type:Organization
Organization Name:HEALING WITH HEART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GENOA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-805-8677
Mailing Address - Street 1:2800 E ENTERPRISE AVE STE 333
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-7889
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:902 GOODMAN CT N
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-1011
Practice Address - Country:US
Practice Address - Phone:443-805-8677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty