Organization
SG MENTAL HEALTH COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENYETTA SHANANEY HOLMES BSW, MSW (MASTER'S LEVEL CLINICAN)
(850) 727-9881
Entity
Organization
Contact information
Practice address
1375A CROSS CREEK CIR, TALLAHASSEE, FL 32301-3729
(850) 425-0206
Mailing address
1374-A CROSS CREEK CIRCLE, TALLAHASSEE, FL 32301
(850) 425-0206
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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