Organization
FIRESIDE HEALING
Active
Organization
FIRESIDE HEALING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY STAPLES (CFO)
(417) 730-9858
Entity
Organization
Contact information
Practice address
1335 E REPUBLIC RD STE H, SPRINGFIELD, MO 65804-7220
(417) 730-9858
Mailing address
PO BOX 14435, SPRINGFIELD, MO 65814-0435
(417) 730-9858
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
04/12/2024
Last updated
05/07/2024
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