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General NPI Number Information
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NPI Number | 1124973268
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Entity Type | Organization
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Legal Business Name | HEALTHY HEARTS SOUND MINDS THERAPY LLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 40056 CAMBRIDGE ST APT 101
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City | CANTON
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State | MI
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Zip | 48187-4543
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Country | US
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Telephone | 586-500-0756
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Fax | 586-261-3163
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Provider Business Mailing Address
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Address Line | 15900 W 10 MILE RD STE 211
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2079
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Country | US
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Telephone | 586-500-0756
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Fax | 586-261-3163
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Authorized Official
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Title or Position | OWNER
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Name | SHARTISHA L HAYSLETT
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Credential | LLMSW, QMHP, QIDP
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Telephone | 586-335-8486
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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