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General NPI Number Information
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NPI Number | 1174094593
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Entity Type | Organization
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Legal Business Name | WHOLE FAMILY HEALING GROUP, LLC
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Dates
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Enumeration Date | 12/11/2018
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 104 CHURCH LN STE 120
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City | PIKESVILLE
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State | MD
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Zip | 21208-3786
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Country | US
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Telephone | 410-413-6043
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Fax | 410-559-6510
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Provider Business Mailing Address
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Address Line | 1325 BEDFORD AVE UNIT 32405
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City | PIKESVILLE
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State | MD
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Zip | 21282-7550
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Country | US
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Telephone | 443-979-3295
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER/OWNER
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Name | MIESHA RICE
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Credential | LCSW-C
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Telephone | 443-979-3295
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #4
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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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