Healthcare Provider Details

I. General information

NPI: 1225656580
Provider Name (Legal Business Name): HEALING SOULUTIONS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 FOLSOM BLVD STE 265
SACRAMENTO CA
95826-3250
US

IV. Provider business mailing address

8801 FOLSOM BLVD STE 265
SACRAMENTO CA
95826-3250
US

V. Phone/Fax

Practice location:
  • Phone: 916-459-1679
  • Fax: 916-647-0141
Mailing address:
  • Phone: 916-459-1679
  • Fax: 916-647-0141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DESTINY ROBBINS
Title or Position: FOUNDER/MEMBER
Credential: LCSW
Phone: 916-236-9409