| Organization Name: | HEALING CONNECTIONS COUNSELING SERVICES, LLC |
| NPI Number: | 1134388358 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIS JEROME BEASLEY (DIRECTOR/ COUNSELOR) |
| Mailing Address: | 333 W Wilcox Dr Suite 303 Sierra Vista |
| State: | AZ US |
| Postal Code: | 856351756 |
| Phone Number: | 5203782613 |
| Fax Number: | 5204585124 |
| NPI Enumeration Date: | 06/03/2008 |
| NPI Last Update Date: | 06/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC10904 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |