Provider Demographics
NPI: | 1366172777 |
---|---|
Name: | HEART AND HONEY COUNSELING |
Entity type: | Organization |
Organization Name: | HEART AND HONEY COUNSELING |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER/OUTPATIENT THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NICOLE |
Authorized Official - Middle Name: | MARIE |
Authorized Official - Last Name: | LEE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | LMFT, LPC |
Authorized Official - Phone: | 570-317-0734 |
Mailing Address - Street 1: | 1000 MARKET ST STE 41 |
Mailing Address - Street 2: | |
Mailing Address - City: | BLOOMSBURG |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 17815-8014 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 570-317-0734 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1000 MARKET ST STE 41 |
Practice Address - Street 2: | |
Practice Address - City: | BLOOMSBURG |
Practice Address - State: | PA |
Practice Address - Zip Code: | 17815-2601 |
Practice Address - Country: | US |
Practice Address - Phone: | 570-317-0734 |
Practice Address - Fax: | 272-207-2967 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-06-16 |
Last Update Date: | 2024-05-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |