Heal It in the Wild LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

HEAL IT IN THE WILD LLC

Practice address

4004 Tin Roof Way
Glen Allen, VA 23059-8050

Phone

(804) 606-0716

NPI assigned

Mar 28, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ashley Fayak, LPCNPI 1588288021

Title

Ceo

Phone

(757) 434-3329

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ashley Kay Fayak, LPC

  • Professional Counselor
  • Portsmouth, VA
  • NPI 1588288021
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1023712528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 TIN ROOF WAY",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230598050",
            "telephone_number": "804-606-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 TIN ROOF WAY",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230598050",
            "telephone_number": "804-606-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL IT IN THE WILD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "FAYAK",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-434-3329",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Journette Hawkes, LPC
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• Kristen Michele Hayes, PMHNP-BC
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• Mental Health Counselor in Glen Allen, VA
• Providers in Glen Allen, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.