| Healing Hearts Llc | |
|
75 Brook Hill Rd Hamden CT 06514-2001 | |
| (203) 623-9786 | |
| (203) 745-4215 |
| Full Name | Healing Hearts Llc |
|---|---|
| Speciality | Social Worker |
| Location | 75 Brook Hill Rd, Hamden, Connecticut |
| Authorized Official Name and Position | Shalita L Sampson (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2036239786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Hearts Llc Po Box 9134 New Haven CT 06532-0134 Ph: (203) 623-9786 | Healing Hearts Llc 75 Brook Hill Rd Hamden CT 06514-2001 Ph: (203) 623-9786 |
| NPI Number | 1467819375 |
|---|---|
| Provider Enumeration Date | 01/22/2016 |
| Last Update Date | 01/22/2016 |
| Medicare PECOS PAC ID | 3072874585 |
|---|---|
| Medicare Enrollment ID | O20180226001085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467819375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 008810 (Connecticut) | Primary |
| Provider Name | Shalita L. Sampson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235552514 PECOS PAC ID: 3577825850 Enrollment ID: I20180326002714 |
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