My Healing Space Counseling PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MY HEALING SPACE COUNSELING PLLC

Practice address

19549 Randolph PL
Denver, CO 80249-8609

Phone

(720) 209-8897

NPI assigned

Apr 11, 2023

Last updated

Aug 1, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Fannie Johnson, CASNPI 1245491422

Title

Certified Addiction Specialist

Phone

(720) 209-8897

Specialties & licenses 1

Addresses

Tax ID family

My Healing Space Counseling PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• My Healing Space Counseling PLLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Aurora, CO
  • NPI 1508618455
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fannie Shariee Johnson, MEDICAL ASISSITANT

  • Addiction (Substance Use Disorder) Counselor
  • Denver, CO
  • NPI 1245491422
  NPD Authorized official

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1235824582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 S HAVANA ST # 11-1150",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800124019",
            "telephone_number": "720-209-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19549 RANDOLPH PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802498609",
            "telephone_number": "720-209-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HEALING SPACE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-08-01",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "FANNIE",
        "authorized_official_title_or_position": "CERTIFIED ADDICTION SPECIALIST",
        "authorized_official_telephone_number": "720-209-8897",
        "authorized_official_credential": "CAS"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Denver, CO
• Providers in Denver, CO by specialty
• Specialist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.