HEAVENLY THERAPEUTIC SERVICES LLC NPI 1184025587

NPI Information

NPI: 1184025587
Provider Name: HEAVENLY THERAPEUTIC SERVICES LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
110 HABERSHAM DR
STE 116
FAYETTEVILLE, GA
ZIP 30214
Phone: (770) 946-2312
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HEAVENLY THERAPEUTIC SERVICES LLC is a professional counselor in Fayetteville, GA. HEAVENLY THERAPEUTIC SERVICES LLC NPI is 1184025587. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

110 HABERSHAM DR
STE 116
FAYETTEVILLE, GA
ZIP 30214-381
Phone: (770) 946-2312

The provider's authorized official is Fredric Darnell Blocker .
The authorized official title is Lpc and has the following contact phone number (770) 946-2312.

The enumeration date for this NPI number is 9/4/2014 and was last updated on 9/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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