| Heartwise Healing Llc | |
|
625 Walden Cir Apt 103 Boulder CO 80305-7606 | |
| (732) 325-5802 | |
| Not Available |
| Full Name | Heartwise Healing Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 625 Walden Cir Apt 103, Boulder, Colorado |
| Authorized Official Name and Position | Caroline Lee (SOCIAL WORKER) |
| Authorized Official Contact | 7323255802 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartwise Healing Llc 625 Walden Cir Apt 103 Boulder CO 80305-7606 Ph: (732) 325-5802 | Heartwise Healing Llc 625 Walden Cir Apt 103 Boulder CO 80305-7606 Ph: (732) 325-5802 |
| NPI Number | 1821777095 |
|---|---|
| Provider Enumeration Date | 07/14/2023 |
| Last Update Date | 07/14/2023 |
| Certification Date | 07/14/2023 |
| Medicare PECOS PAC ID | 5496104465 |
|---|---|
| Medicare Enrollment ID | O20231215001964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821777095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Caroline Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932847597 PECOS PAC ID: 2062877640 Enrollment ID: I20230504000514 |
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