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General NPI Number Information
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NPI Number | 1982335386
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Entity Type | Organization
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Legal Business Name | HOPE FOR HEALING LLC
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 03/15/2025
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Provider Practice Location Address
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Address Line | 114 BALL AVE
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City | TYLERTOWN
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State | MS
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Zip | 39667-2102
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Country | US
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Telephone | 601-303-0154
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Fax |
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Provider Business Mailing Address
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Address Line | 114 BALL AVE
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City | TYLERTOWN
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State | MS
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Zip | 39667-2102
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Country | US
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Telephone | 601-303-0154
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER LLC
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Name | LACEY HOLMES
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Credential | LCSW
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Telephone | 601-303-0154
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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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