Provider Demographics
NPI:1902612476
Name:HEALING COUNSEL CHRISTIAN COUNSELING, LLC
Entity type:Organization
Organization Name:HEALING COUNSEL CHRISTIAN COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORRINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-853-2358
Mailing Address - Street 1:10370 THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:PA
Mailing Address - Zip Code:16111-1344
Mailing Address - Country:US
Mailing Address - Phone:814-550-4969
Mailing Address - Fax:
Practice Address - Street 1:39 HADLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1239
Practice Address - Country:US
Practice Address - Phone:814-550-4969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty