Provider Demographics
NPI:1154797082
Name:HEART TO HEART COUNSELING AND WELLNESS CENTER, PLLC
Entity type:Organization
Organization Name:HEART TO HEART COUNSELING AND WELLNESS CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHENAE
Authorized Official - Middle Name:LASANDRA
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MA, LPA, LCMHCS
Authorized Official - Phone:910-867-4417
Mailing Address - Street 1:5845 YADKIN RD UNIT D
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2656
Mailing Address - Country:US
Mailing Address - Phone:910-867-4417
Mailing Address - Fax:910-302-7479
Practice Address - Street 1:5845 YADKIN RD UNIT D
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-2656
Practice Address - Country:US
Practice Address - Phone:910-867-4417
Practice Address - Fax:910-302-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 103T00000X
NC8992251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty