Organization
HEALING IDENTITIES COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KANAKA KEONNE HENRY LCSW (OWNER)
(870) 253-8082
Entity
Organization
Contact information
Practice address
900 DORMAN ST STE A, SPRINGDALE, AR 72762-5101
(479) 755-3501
Mailing address
900 DORMAN ST STE A, SPRINGDALE, AR 72762-5101
(479) 755-3501
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/01/2024
Last updated
05/28/2024
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