Wholehearted Healing Counseling LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

WHOLEHEARTED HEALING COUNSELING LLC

Practice address

271B S Culver St Ste H
Lawrenceville, GA 30046-4805

Phone

(678) 824-5899

NPI assigned

May 24, 2016

Last updated

Dec 10, 2024By 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

Nicole Chacin, LPCNPI 1679726376

Title

Owner

Phone

(678) 824-5899

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Nicole Chacin, LPC

  • Counseling Psychologist
  • Lawrenceville, GA
  • NPI 1679726376
  NPD Authorized official

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1326496902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "271B S CULVER ST STE H",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464805",
            "telephone_number": "719-290-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271B S CULVER ST STE H",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464805",
            "telephone_number": "678-824-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLEHEARTED HEALING COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-24",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "CHACIN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-824-5899",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "008888",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12573679",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jani Widjaja, MD
• Raegan Wieder

• Counseling Psychologist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Counseling Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.