Provider Demographics
NPI:1457949679
Name:HEALING LEGACY COUNSELING LLC
Entity type:Organization
Organization Name:HEALING LEGACY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HAYLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, MFT
Authorized Official - Phone:330-810-6860
Mailing Address - Street 1:591 BOSTON MILLS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-1197
Mailing Address - Country:US
Mailing Address - Phone:330-810-6860
Mailing Address - Fax:
Practice Address - Street 1:591 BOSTON MILLS RD STE 500
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1197
Practice Address - Country:US
Practice Address - Phone:330-810-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1174024491Medicaid
OH1255632816Medicaid