Healing Source LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

HEALING SOURCE LLC

Practice address

153 E Chestnut Hill Rd Ste 209
Newark, DE 19713-4047

Phone

(302) 509-5888

NPI assigned

Dec 21, 2019

Organization subpart

No

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

Authorized official

Name

Jodi WillemsNPI 1841733136

Title

Owner

Phone

(302) 981-2701

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Locations

Practitioners 1

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

• Jodi Willems, LCPC

  • Mental Health Counselor
  • Newark, DE
  • NPI 1841733136
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1576886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1194364141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 STAMFORD DR APT 111",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197112789",
            "telephone_number": "302-981-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 E CHESTNUT HILL RD STE 209",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134047",
            "telephone_number": "302-509-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING SOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-21",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "WILLEMS",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-981-2701"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Newark, DE
• Providers in Newark, DE by specialty
• Mental Health Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.