Provider Demographics
NPI:1063299071
Name:HEALING ELEMENTS COUNSELING
Entity type:Organization
Organization Name:HEALING ELEMENTS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:216-714-3128
Mailing Address - Street 1:15887 SNOW RD
Mailing Address - Street 2:
Mailing Address - City:BROOKPARK
Mailing Address - State:OH
Mailing Address - Zip Code:44142-2858
Mailing Address - Country:US
Mailing Address - Phone:216-714-3128
Mailing Address - Fax:888-892-2977
Practice Address - Street 1:15887 SNOW RD
Practice Address - Street 2:
Practice Address - City:BROOKPARK
Practice Address - State:OH
Practice Address - Zip Code:44142-2858
Practice Address - Country:US
Practice Address - Phone:216-571-2909
Practice Address - Fax:888-892-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-12
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0270050Medicaid