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Organization
CSA PSYCHIATRIC HEALING CENTER LLC
Active
Organization
CSA PSYCHIATRIC HEALING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAISOPHIA HARPER MSN, APRN, PMHNP (ADMINISTRATOR)
(404) 621-4535
Entity
Organization
Contact information
Practice address
327 W MAIN ST, THOMASTON, GA 30286-3502
(404) 621-4535
Mailing address
17 HAMPTON ST STE E, MCDONOUGH, GA 30253-3159
(404) 621-4535
(404) 621-4535
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
NULL
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/29/2025
Last updated
05/29/2025
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