Provider Demographics
NPI:1063971851
Name:HEALING ESSENCE PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:HEALING ESSENCE PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:BETINA
Authorized Official - Last Name:DE SOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:954-629-0248
Mailing Address - Street 1:4500 BISCAYNE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3227
Mailing Address - Country:US
Mailing Address - Phone:305-571-9090
Mailing Address - Fax:305-571-7800
Practice Address - Street 1:4500 BISCAYNE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3227
Practice Address - Country:US
Practice Address - Phone:305-571-9090
Practice Address - Fax:305-571-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty