Provider Demographics
NPI:1538935721
Name:HEARTHSTONE THERAPY SERVICES LLC.
Entity type:Organization
Organization Name:HEARTHSTONE THERAPY SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:DAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-675-8002
Mailing Address - Street 1:380 S 5TH ST # 313
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-1352
Mailing Address - Country:US
Mailing Address - Phone:541-675-8002
Mailing Address - Fax:541-460-5593
Practice Address - Street 1:404 NW BIRCH LN
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-9082
Practice Address - Country:US
Practice Address - Phone:541-675-8002
Practice Address - Fax:541-460-5593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty