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General NPI Number Information
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NPI Number | 1508556945
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Entity Type | Organization
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Legal Business Name | WHOLENESS CLINICAL MENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 05/09/2023
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Last Update Date | 05/09/2023
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Provider Practice Location Address
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Address Line | 3665 OLD HIGHWAY 77
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9101
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Country | US
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Telephone | 956-801-2064
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Fax |
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Provider Business Mailing Address
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Address Line | 3665 OLD HIGHWAY 77
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City | BROWNSVILLE
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State | TX
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Zip | 78520-9101
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Country | US
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Telephone | 956-801-2064
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Fax |
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Authorized Official
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Title or Position | EMPLOYEE
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Name | SHANNA LYNN BOONE
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Credential | LPC-A
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Telephone | 956-459-4685
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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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