Organization Active NPI

Healing Space Therapy, LLC

  • Marriage & Family Therapist
  • Delray Beach, FL
National Provider Identifier
1245938117
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
HEALING SPACE THERAPY, LLC
Practice address
15200 S Jog Rd Ste 303
Delray Beach, FL 33446-1249
Phone
(561) 501-1054
NPI assigned
Feb 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Authorized official

Name
Emily KonickiNPI 1841968906
Title
Owner
Phone
(478) 508-0915

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

15200 S Jog Rd Ste 303
Delray Beach, FL 33446-1249

Mailing address

601 SW Stuart West Blvd
Palm City, FL 34990-6240
Phone (478) 508-0915

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1245938117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SW STUART WEST BLVD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349906240",
            "telephone_number": "478-508-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 S JOG RD STE 303",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334461249",
            "telephone_number": "561-501-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING SPACE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "KONICKI",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-508-0915"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.