Provider Demographics
NPI:1306339296
Name:HEALING TRUTH CENTER LLC
Entity type:Organization
Organization Name:HEALING TRUTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AARONS-COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:917-771-7785
Mailing Address - Street 1:200 NORTH AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-6447
Mailing Address - Country:US
Mailing Address - Phone:917-740-6449
Mailing Address - Fax:914-355-2379
Practice Address - Street 1:200 NORTH AVE STE 4
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-6447
Practice Address - Country:US
Practice Address - Phone:917-740-6449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0787761041C0700X
261QM0801X, 261QM1300X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty