Provider Demographics
NPI:1568282325
Name:ESSENTIAL HEALING LLC
Entity type:Organization
Organization Name:ESSENTIAL HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ESSENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER-MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:716-472-6673
Mailing Address - Street 1:52 PARK MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3868
Mailing Address - Country:US
Mailing Address - Phone:716-472-6673
Mailing Address - Fax:
Practice Address - Street 1:52 PARK MEADOW DR
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3868
Practice Address - Country:US
Practice Address - Phone:716-472-6673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health