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General NPI Number Information
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NPI Number | 1811306020
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Entity Type | Organization
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Legal Business Name | THE HEALING CREST COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 2500 HOLLYWOOD BLVD STE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6615
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Country | US
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Telephone | 754-777-6871
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 HOLLYWOOD BLVD STE 103
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6615
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Country | US
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Telephone | 754-777-6871
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. LAMORA D PACE
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Credential | LCSW, CAP
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Telephone | 954-702-9021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP ADC-001430-2014
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CCMS100206-AC
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | SW9459
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License Number State | FL
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