Provider Demographics
NPI:1154797447
Name:HEALING HEARTS THERAPY CENTER, INC
Entity type:Organization
Organization Name:HEALING HEARTS THERAPY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD, LMHC, CAP
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:KHACHATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMHC, CAP
Authorized Official - Phone:305-742-5429
Mailing Address - Street 1:3964 NW 85TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5022
Mailing Address - Country:US
Mailing Address - Phone:954-634-4292
Mailing Address - Fax:954-671-1222
Practice Address - Street 1:4801 S UNIVERSITY DR STE 417
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3843
Practice Address - Country:US
Practice Address - Phone:954-634-4292
Practice Address - Fax:954-671-1222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty