Provider Demographics
NPI:1447028709
Name:ENLIGHTENED HEARTS PSYCHOTHERAPY, LLC
Entity type:Organization
Organization Name:ENLIGHTENED HEARTS PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PICHE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:914-440-0772
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:DE
Mailing Address - Zip Code:19962-0035
Mailing Address - Country:US
Mailing Address - Phone:914-440-0772
Mailing Address - Fax:
Practice Address - Street 1:454 W BIRDIE LN
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:DE
Practice Address - Zip Code:19962-3261
Practice Address - Country:US
Practice Address - Phone:914-440-0772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)