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: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 HALL ST STE 15
HAYS KS
67601-1964
US

IV. Provider business mailing address

213 E 32ND ST
HAYS KS
67601-1626
US

V. Phone/Fax

Practice location:
  • Phone: 254-716-6569
  • Fax:
Mailing address:
  • Phone: 254-716-6569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: TAISA T CARVALHO MICK
Title or Position: OWNER
Credential: LMLP
Phone: 254-716-6569