Provider Demographics
NPI:1023675477
Name:HAPPY HEALTHY HEALING PLLC
Entity type:Organization
Organization Name:HAPPY HEALTHY HEALING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:816-405-7499
Mailing Address - Street 1:14808 MILLICENT CT
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1867
Mailing Address - Country:US
Mailing Address - Phone:816-405-7499
Mailing Address - Fax:703-543-2639
Practice Address - Street 1:5675 STONE RD.
Practice Address - Street 2:SUITE 310
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120
Practice Address - Country:US
Practice Address - Phone:816-405-7499
Practice Address - Fax:703-543-2639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-21
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701007134OtherLICENSE
VA3001745073001Medicaid