Organization
HOLISTIC HEALING THERAPY, LLC
Active
Other names
Creative Counseling, Consulting and Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN CLARK LCSW (CEO/OWNER)
(601) 383-2784
Entity
Organization
Contact information
Practice address
3304 N STATE ST # 201A, JACKSON, MS 39216-3129
(601) 345-1370
Mailing address
410 BEAVER CREEK DR, RIDGELAND, MS 39157-2114
(160) 138-3278
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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