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Organization
HOLISTIC HEALING THERAPY, LLC
Active
Organization
HOLISTIC HEALING THERAPY, LLC
Active
Other names
Creative Counseling, Consulting and Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN CLARK LCSW (CEO/OWNER)
(601) 383-2784
Entity
Organization
Contact information
Practice address
3304 N STATE ST # 201A, JACKSON, MS 39216-3129
(601) 345-1370
Mailing address
410 BEAVER CREEK DR, RIDGELAND, MS 39157-2114
(160) 138-3278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
320800000X
Mental Illness Community Based Residential Treatment Facility
—
NULL
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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