Basic Information
Provider Information
NPI: 1356783542
EntityType: 2
ReplacementNPI:  
OrganizationName: HEARTFELT CHRISTIAN COUNSELING, PLLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 299
Address2:  
City: ROWLETT
State: TX
PostalCode: 750300299
CountryCode: US
TelephoneNumber: 9729962242
FaxNumber: 9729962245
Practice Location
Address1: 4702 ROWLETT RD
Address2: SUITE 101
City: ROWLETT
State: TX
PostalCode: 750881703
CountryCode: US
TelephoneNumber: 9729962242
FaxNumber: 9729962245
Other Information
ProviderEnumerationDate: 07/29/2013
LastUpdateDate: 07/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HAMMAN
AuthorizedOfficialFirstName: THOMAS
AuthorizedOfficialMiddleName: ROSS
AuthorizedOfficialTitleorPosition: BUSINESS MANAGER
AuthorizedOfficialTelephone: 9729962242
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X65581TXY193400000X SINGLE SPECIALTY GROUPBehavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


Home