Organization
HEALING PLACE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. TAMARA LEE IMEL MA, LMHC (OWNER)
(765) 744-9597
Entity
Organization
Contact information
Practice address
1811 BUNDY AVE, NEW CASTLE, IN 47362-2973
(765) 744-9597
Mailing address
744 HAWTHORN RD, NEW CASTLE, IN 47362-5236
(765) 744-9597
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39001395A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000194594
ANTHEM
IN
Enumeration date
06/09/2016
Last updated
06/09/2016
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