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General NPI Number Information
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NPI Number | 1821549627
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Entity Type | Organization
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Legal Business Name | HEALING & GROWTH COUNSELING SERVICES
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 10/18/2016
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Provider Practice Location Address
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Address Line | 107 WATER ST #206
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City | BENTON HARBOR
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State | MI
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Zip | 49022-3451
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Country | US
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Telephone | 269-861-5084
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Fax |
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Provider Business Mailing Address
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Address Line | 107 WATER ST #206
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City | BENTON HARBOR
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State | MI
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Zip | 49022-3451
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Country | US
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Telephone | 269-861-5084
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. THORA GREAVES
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Credential | LMSW
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Telephone | 269-861-5084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801077510
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License Number State | MI
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