Organization
HEALING HEARTS
Active
Other names
A Center 4 Change
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STEPHANIE PHELPS (CHIEF OPERATING OFFICER)
(606) 393-5586
Entity
Organization
Contact information
Practice address
2205 CARTER AVE, ASHLAND, KY 41101-7823
(606) 393-5586
Mailing address
PO BOX 5074, ASHLAND, KY 41105-5074
(606) 393-5586
(606) 928-5547
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
8002222
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7199412810
—
KY
Enumeration date
07/30/2018
Last updated
07/30/2018
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