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General NPI Number Information
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NPI Number | 1831151463
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Entity Type | Organization
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Legal Business Name | HOLISTIC MENTAL HEALTH INC
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 2211 TODDS LANE
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City | HAMPTON
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State | VA
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Zip | 23666
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Country | US
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Telephone | 757-826-2514
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Fax | 757-826-5560
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Provider Business Mailing Address
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Address Line | PO BOX 8084
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City | HAMPTON
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State | VA
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Zip | 23666
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Country | US
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Telephone | 757-826-2514
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Fax | 757-826-5560
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Authorized Official
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Title or Position | DIRECTOR PRESIDENT HOLISTIC MENTAL
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Name | CLARA ELIZABETH EWING
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Credential | LMFT LPC CSAC
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Telephone | 757-826-2514
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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