Healthcare Provider Details

I. General information

NPI: 1972369205
Provider Name (Legal Business Name): HOLISTIC HEALING AND COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8603 S DIXIE HWY STE 217
PINECREST FL
33156-1160
US

IV. Provider business mailing address

8603 S DIXIE HWY STE 217
PINECREST FL
33156-1160
US

V. Phone/Fax

Practice location:
  • Phone: 786-519-3410
  • Fax:
Mailing address:
  • Phone: 786-519-3410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: XOTCHILT C BLANCO
Title or Position: MANAGING MEMBER
Credential: LMHC
Phone: 786-519-3410