Healthcare Provider Details

I. General information

NPI: 1255263778
Provider Name (Legal Business Name): INTENTIONAL HEALING ESSENCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 AUSTIN BLVD STE 600 PMB 1051
RED OAK TX
75154
US

IV. Provider business mailing address

101 AUSTIN BLVD STE 600 PMB 1051
RED OAK TX
75154
US

V. Phone/Fax

Practice location:
  • Phone: 313-595-1210
  • Fax:
Mailing address:
  • Phone:
  • 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: MS. BRITTANY C.L. JONES
Title or Position: OWNER
Credential: LCSW
Phone: 313-595-1210