Organization Active NPI

Healing Wounds LLC

  • Psychologist
  • Scottsdale, AZ
National Provider Identifier
1780033787
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
AZ 4696 Issued in AZ
Legal business name
HEALING WOUNDS LLC
Practice address
8300 N Hayden Rd
Ste a-108
Scottsdale, AZ 85258-2458
Phone
(210) 355-6207
Fax
(480) 467-0248
NPI assigned
Jun 9, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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

Authorized official

Name
Sonja Louise Raciti, D.ONPI 1194966093
Title
Owner
Phone
(210) 355-6207

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
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X AZ 4696 AZ Primary

Addresses

Primary practice location

8300 N Hayden Rd
Ste a-108
Scottsdale, AZ 85258-2458

Mailing address

8300 N Hayden Rd
Ste a-108
Scottsdale, AZ 85258-2458
Phone (210) 355-6207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160708000216 AZ Part B Supplier - Clinic/Group Practice 1254623432 Receives reassigned benefits from 4 practitioners
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

8160 E Butherus Dr
Ste 5
Scottsdale, AZ 85260
Phone (210) 355-6207

8300 N Hayden Rd
Ste A117
Scottsdale, AZ 85258
Phone (210) 355-6207

8300 N Hayden Rd
Ste A108
Scottsdale, AZ 85258
Phone (210) 355-6207

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465430400000",
    "number": "1780033787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 N HAYDEN RD",
            "address_2": "STE A-108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852582458",
            "telephone_number": "210-355-6207",
            "fax_number": "480-467-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 N HAYDEN RD",
            "address_2": "STE A-108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852582458",
            "telephone_number": "210-355-6207",
            "fax_number": "480-467-0248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING WOUNDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2016-06-09",
        "status": "A",
        "authorized_official_last_name": "RACITI",
        "authorized_official_first_name": "SONJA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-355-6207",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "AZ 4696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2016; 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.