Healthcare Provider Details

I. General information

NPI: 1073409801
Provider Name (Legal Business Name): THE HEALING THREAD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E 7TH ST STE D
HAYS KS
67601-4168
US

IV. Provider business mailing address

PO BOX 133
HAYS KS
67601-0133
US

V. Phone/Fax

Practice location:
  • Phone: 254-716-6569
  • Fax:
Mailing address:
  • Phone: 785-639-5525
  • 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: TAISA T CARVALHO MICK
Title or Position: OWNER
Credential: LMLP
Phone: 254-716-6569