# HOLISTIC HEALING THERAPY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Creative Counseling, Consulting and Behavioral Health Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972236917
- **Authorized official:** ROBIN CLARK LCSW (CEO/OWNER)
- **Authorized official phone:** (601) 383-2784

## Contact information

- **Practice address:** 3304 N STATE ST \# 201A, JACKSON, MS 39216-3129
- **Practice address phone:** (601) 345-1370
- **Mailing address:** 410 BEAVER CREEK DR, RIDGELAND, MS 39157-2114
- **Mailing address phone:** (160) 138-3278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 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