# DIVINE HEALING SPACE, PLLC

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

## Provider details

- **NPI number:** 1417521907
- **Authorized official:** MRS. JASMINE BATTLES LCSW (OWNER/ CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (504) 410-0031

## Contact information

- **Practice address:** 12222 MERIT DR \# 130, DALLAS, TX 75251-2217
- **Practice address phone:** (504) 410-0031
- **Mailing address:** 12222 MERIT DR \# 130, DALLAS, TX 75251-2217
- **Mailing address phone:** (504) 410-0031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |

## Other

- **Enumeration date:** 05/18/2021
- **Last updated:** 05/18/2021