Healthcare Provider Details

I. General information

NPI: 1861302002
Provider Name (Legal Business Name): HEAD HEART AND SOUL MENTAL HEALTH COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1985 TATE BLVD SE STE 5
HICKORY NC
28602-1433
US

IV. Provider business mailing address

308 1ST AVENUE PL NE
CONOVER NC
28613-2215
US

V. Phone/Fax

Practice location:
  • Phone: 828-238-0644
  • Fax:
Mailing address:
  • Phone: 828-238-0644
  • 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

VIII. Authorized Official

Name: MRS. KIMBERLY HARSHAW MATTHEWS HARSHAW
Title or Position: OWNER/OUTPATIENT COUNSELOR
Credential: LCMHCS
Phone: 828-238-0644