Provider Demographics
NPI:1427889070
Name:CONNECTED HEALING COUNSELING LLC
Entity type:Organization
Organization Name:CONNECTED HEALING COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC LAC
Authorized Official - Phone:605-212-2946
Mailing Address - Street 1:1109 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GARRETSON
Mailing Address - State:SD
Mailing Address - Zip Code:57030-2011
Mailing Address - Country:US
Mailing Address - Phone:605-212-2946
Mailing Address - Fax:
Practice Address - Street 1:101 S REID ST STE 307
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-7045
Practice Address - Country:US
Practice Address - Phone:605-212-2946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)