# HEALING HEART MOMENTS, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215578943
- **Authorized official:** DR. CARMAN SUZANNE CLARK PHD (PSYCHOLOGIST/LICENSED COUNSELOR)
- **Authorized official phone:** (678) 215-7236

## Contact information

- **Practice address:** 149 LEE BYRD RD STE 11, LOGANVILLE, GA 30052-2310
- **Practice address phone:** (678) 215-7236
- **Mailing address:** 149 LEE BYRD RD STE 11, LOGANVILLE, GA 30052-2310
- **Mailing address phone:** (678) 215-7236

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP1600X | Pastoral Counselor | — | NULL | Yes |
| 101YP1600X | Pastoral Counselor | — | — | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 101YS0200X | School Counselor | — | NULL | — |
| 101YS0200X | School Counselor | — | — | — |
| 103G00000X | Clinical Neuropsychologist | — | NULL | — |
| 103G00000X | Clinical Neuropsychologist | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | NULL | — |
| 103TB0200X | Cognitive & Behavioral Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | — |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | — |
| 103TF0200X | Forensic Psychologist | — | NULL | — |
| 103TF0200X | Forensic Psychologist | — | — | — |
| 103TH0004X | Health Psychologist | — | NULL | — |
| 103TH0004X | Health Psychologist | — | — | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |
| 103TS0200X | School Psychologist | — | NULL | — |
| 103TS0200X | School Psychologist | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 10/03/2019
- **Last updated:** 08/11/2021