MEDICARE: THE HEALING HUMAN COLLECTIVE PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1700679867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE HEALING HUMAN COLLECTIVE PLLC

Provider Business Mailing Address
First Line	:	1818 E SOUTHERN AVE STE 3A
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-5247
Country	:	US
Telephone Number	:	480-536-5008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1818 E SOUTHERN AVE STE 3A
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85204-5247
Country	:	US
Telephone Number	:	480-536-5008
Fax Number	:

Authorized Official
Title or Position	:	OWNER & FOUNDER
Name	:	DR. LATISHA CHANEL BROWN
Credential	:	LCSW, DBH
Telephone Number	:	480-536-5008

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	05/27/2025

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