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General NPI Number Information
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NPI Number | 1275885881
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Entity Type | Organization
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Legal Business Name | A HEALING PLACE, LLC
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 207 1ST ST
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City | JACKSON
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State | MI
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Zip | 49201-2102
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Country | US
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Telephone | 517-425-4547
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Fax |
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Provider Business Mailing Address
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Address Line | 207 1ST ST.
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City | JACKSON
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State | MI
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Zip | 49201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | C.F.O./OWNER
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Name | RACHEL FLOWERS
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Credential | LMSW
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Telephone | 517-425-4547
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 6301010931
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6301010931
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 6301010931
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801090038
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801090474
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801090038
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801090474
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 6301010931
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License Number State | MI
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