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General NPI Number Information
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NPI Number | 1942616735
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Entity Type | Organization
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Legal Business Name | HEALING TREE COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/01/2014
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Provider Practice Location Address
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Address Line | 979 GLENWOOD AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-1815
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Country | US
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Telephone | 404-600-8859
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Fax | 404-600-8859
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Provider Business Mailing Address
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Address Line | 979 GLENWOOD AVE SE
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City | ATLANTA
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State | GA
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Zip | 30316-1815
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Country | US
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Telephone | 404-600-8859
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Fax | 404-600-8859
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MISS TERESA NADINE SILVA
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Credential | LCSW
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Telephone | 678-849-9463
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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 | CSW005061
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License Number State | GA
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