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General NPI Number Information
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NPI Number | 1275900441
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Entity Type | Organization
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Legal Business Name | HEALING HEART COUNSELING AND CONSULTING, LLC
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 05/14/2016
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Provider Practice Location Address
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Address Line | 3800 INVERRARY BLVD SUITE 308Q
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City | LAUDERHILL
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State | FL
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Zip | 33319-4382
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Country | US
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Telephone | 561-313-5842
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Fax |
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Provider Business Mailing Address
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Address Line | 7041 NW 5TH ST
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City | PLANTATION
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State | FL
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Zip | 33317-1601
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Country | US
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Telephone | 561-313-5842
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. YASMINE DECLAMA HOLBROOK
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Credential | LCSW
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Telephone | 561-313-5842
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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 | SW12861
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License Number State | FL
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