Provider Demographics
NPI:1306483706
Name:HEALING JOURNEY COUNSELING PLLC
Entity type:Organization
Organization Name:HEALING JOURNEY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIACICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-890-5123
Mailing Address - Street 1:4581 VAL CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9522
Mailing Address - Country:US
Mailing Address - Phone:989-890-5123
Mailing Address - Fax:
Practice Address - Street 1:240 W MAIN ST STE 2600
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-5191
Practice Address - Country:US
Practice Address - Phone:989-890-5123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health