| Organization Name: | HEALING MINDS CLINIC, PLLC |
| NPI Number: | 1023370434 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMY NICOLE HEBB (LICENSED PSYCHOLOGIST) |
| Mailing Address: | 65 Professional Place Suite 101 Bridgeport |
| State: | WV US |
| Postal Code: | 26330 |
| Phone Number: | 3048426463 |
| Fax Number: | 3048428180 |
| NPI Enumeration Date: | 06/12/2012 |
| NPI Last Update Date: | 05/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 1038 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |