MEDICARE: HEALING MINDS COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1730798117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING MINDS COUNSELING LLC

Provider Business Mailing Address
First Line	:	5300 N MERIDIAN AVE STE 11
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2179
Country	:	US
Telephone Number	:	405-887-9267
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 N MERIDIAN AVE STE 11
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2179
Country	:	US
Telephone Number	:	405-887-9267
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASMIN SMITH
Credential	:	LPC
Telephone Number	:	405-887-9267

Provider Enumeration Date	:	07/30/2020
Last Update Date	:	04/17/2024

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