Provider Demographics
NPI:1750872941
Name:HEALING SPACE LLC
Entity type:Organization
Organization Name:HEALING SPACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ATTIA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-937-8872
Mailing Address - Street 1:708 BEAUMONT DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-2910
Mailing Address - Country:US
Mailing Address - Phone:814-937-8872
Mailing Address - Fax:
Practice Address - Street 1:HEALING SPACE LLC
Practice Address - Street 2:206 B ALLEGHENY STREET
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648
Practice Address - Country:US
Practice Address - Phone:814-937-8872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005266101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty