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General NPI Number Information
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NPI Number | 1619545621
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Entity Type | Organization
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Legal Business Name | HEALING MINDS COUNSELING CENTER LLC
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 315 HIGHWAY 80 E
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City | CLINTON
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State | MS
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Zip | 39056-4717
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Country | US
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Telephone | 601-488-4852
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Fax | 601-488-4091
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Provider Business Mailing Address
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Address Line | 315 HIGHWAY 80 E
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City | CLINTON
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State | MS
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Zip | 39056-4717
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Country | US
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Telephone | 601-488-4852
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Fax | 601-488-4091
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. LASHUNDRA CLARK
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Credential | LPC
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Telephone | 601-488-4852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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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