1619006285 NPI number — HEART TO HEART CHRISTIAN COUNSELING LLC

Table of content: (NPI 1619006285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619006285 NPI number — HEART TO HEART CHRISTIAN COUNSELING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEART TO HEART CHRISTIAN COUNSELING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619006285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6951 VIRGINIA PKWY
Provider Second Line Business Mailing Address:
SUITE 318
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75071-5713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
417-893-9298
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6951 VIRGINIA PKWY
Provider Second Line Business Practice Location Address:
318
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75071-5713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
417-893-9298
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GALVIN DELSOL
Authorized Official First Name:
VEARL
Authorized Official Middle Name:
DEAN
Authorized Official Title or Position:
LICENSED CLINICAL PROFESSIONAL COUN
Authorized Official Telephone Number:
417-893-9298

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  180005826 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YM0800X , with the licence number: 180-005826 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP1600X , with the licence number: 180-005826 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 180-005826 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YS0200X , with the licence number: 180-005826 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: 180-005826 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 323486553001 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".