NPIMap

Organization Active NPI

Healing Hearts Counseling Center LLC

  • Professional Counselor
  • Douglasville, GA
National Provider Identifier
1336508605
Registry record updated Feb 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC007613 Issued in GA
Legal business name
HEALING HEARTS COUNSELING CENTER LLC
Practice address
2366 Old Lower River Rd
Douglasville, GA 30135-3022
Phone
(678) 895-5681
Fax
(877) 575-9128
NPI assigned
Feb 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2016

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

Authorized official

Name
Heather Lavinia Conyers, LPC, NCC
Title
Founder and Therapist
Phone
(678) 895-5681

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X GA
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X LPC007613 GA Primary

Addresses

Primary practice location

2366 Old Lower River Rd
Douglasville, GA 30135-3022

Mailing address

8310 Office Park Dr
Suite 1a
Douglasville, GA 30134-6935
Phone (678) 895-5681

Other identifiers 1

IdentifierTypeStateIssuer
003147662AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Healing Hearts Counseling Center LLC2 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.

Locations

8310 Office Park Dr
Ste 1A
Douglasville, GA 30134

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455580800000",
    "number": "1336508605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 OFFICE PARK DR",
            "address_2": "SUITE 1A",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301346935",
            "telephone_number": "678-895-5681",
            "fax_number": "877-575-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2366 OLD LOWER RIVER RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301353022",
            "telephone_number": "678-895-5681",
            "fax_number": "877-575-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING HEARTS COUNSELING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-02-16",
        "status": "A",
        "authorized_official_last_name": "CONYERS",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "LAVINIA",
        "authorized_official_title_or_position": "FOUNDER AND THERAPIST",
        "authorized_official_telephone_number": "678-895-5681",
        "authorized_official_credential": "LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003147662A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2016; 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.