Provider Demographics
NPI:1861054512
Name:WHOLE AND HOLY INTEGRATIVE WELLNESS LLC
Entity type:Organization
Organization Name:WHOLE AND HOLY INTEGRATIVE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:717-217-9380
Mailing Address - Street 1:166 S MAIN ST # 203
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-2532
Mailing Address - Country:US
Mailing Address - Phone:717-746-8750
Mailing Address - Fax:717-754-2844
Practice Address - Street 1:166 S MAIN ST # 203
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-2532
Practice Address - Country:US
Practice Address - Phone:717-746-8750
Practice Address - Fax:717-754-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-02
Last Update Date:2022-02-24
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