Provider Demographics
NPI:1679311005
Name:HEALE ABA, LLC
Entity type:Organization
Organization Name:HEALE ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-205-0098
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38802-0068
Mailing Address - Country:US
Mailing Address - Phone:662-205-0098
Mailing Address - Fax:662-495-4079
Practice Address - Street 1:1893 CLIFF GOOKIN BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6558
Practice Address - Country:US
Practice Address - Phone:662-205-0098
Practice Address - Fax:662-495-4079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty