# HEALING HEARTS THERAPEUTIC SERVICES, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053498683
- **Authorized official:** MRS. DEMETRIOUS SHEPARD LPC (CEO CLINICAL DIRECTOR)
- **Authorized official phone:** (910) 347-1694

## Contact information

- **Practice address:** 824 GUM BRANCH RD STE E, JACKSONVILLE, NC 28540-6269
- **Practice address phone:** (910) 347-1694
- **Practice address fax:** (910) 347-3691
- **Mailing address:** 824 GUM BRANCH RD STE E, JACKSONVILLE, NC 28540-6269
- **Mailing address phone:** (910) 347-1694
- **Mailing address fax:** (910) 347-3691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |

## Other

- **Enumeration date:** 11/01/2006
- **Last updated:** 07/20/2012