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General NPI Number Information
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NPI Number | 1821719907
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Entity Type | Organization
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Legal Business Name | HEALING SOL COUNSELING COLLECTIVE LLC
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 388 STATE ST STE 500
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City | SALEM
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State | OR
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Zip | 97301-3671
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Country | US
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Telephone | 503-867-8681
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 123
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City | SALEM
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State | OR
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Zip | 97308-0123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KARLA ANGELICA FLORES MARTINEZ
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Credential | LCSW
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Telephone | 503-867-8681
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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 |
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License Number State |
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