Provider Demographics
NPI:1932663267
Name:WHOLEHEARTED THERAPY LLC
Entity Type:Organization
Organization Name:WHOLEHEARTED THERAPY LLC
Other - Org Name:WHOLEHEARTED THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-859-0291
Mailing Address - Street 1:32 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:LEICESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01524-1904
Mailing Address - Country:US
Mailing Address - Phone:508-859-0291
Mailing Address - Fax:
Practice Address - Street 1:32 LAKE AVE
Practice Address - Street 2:
Practice Address - City:LEICESTER
Practice Address - State:MA
Practice Address - Zip Code:01524-1904
Practice Address - Country:US
Practice Address - Phone:774-371-1034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health