Organization
HIGHER GROUND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORY MOODY LISW (OWNER)
(740) 562-6500
Entity
Organization
Contact information
Practice address
1616 W CHURCH ST STE A, NEWARK, OH 43055-1540
(740) 562-6500
Mailing address
514 ARLINGTON AVE, NEWARK, OH 43055-6886
(740) 562-6500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437667755
—
OH
Enumeration date
04/08/2022
Last updated
05/18/2022
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