Healthcare Provider Details

I. General information

NPI: 1538994918
Provider Name (Legal Business Name): HONEYCOMB HEALING ARTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3230 LAKE RD
MATTOON IL
61938-8628
US

IV. Provider business mailing address

3230 LAKE RD
MATTOON IL
61938-8628
US

V. Phone/Fax

Practice location:
  • Phone: 217-358-0697
  • Fax:
Mailing address:
  • Phone: 217-358-0697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: SARA KIRKPATRICK
Title or Position: DIRECTOR
Credential: LCSW
Phone: 217-358-0697