Provider Demographics
NPI:1053164855
Name:HEALING HOUR THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORP.
Entity type:Organization
Organization Name:HEALING HOUR THERAPY, A LICENSED CLINICAL SOCIAL WORKER CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:BILEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TECLEMARIAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:424-502-2829
Mailing Address - Street 1:777 S ALAMEDA ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-1657
Mailing Address - Country:US
Mailing Address - Phone:424-502-2829
Mailing Address - Fax:
Practice Address - Street 1:777 S ALAMEDA ST FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1657
Practice Address - Country:US
Practice Address - Phone:424-502-2829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health