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NPI Code Detail

MEDICARE: HOLISTIC THERAPEUTIC SERVICES, PLLC

MEDICARE: HOLISTIC THERAPEUTIC SERVICES, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1740815125
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOLISTIC THERAPEUTIC SERVICES, PLLC
Provider Business Mailing Address
First Line : 1031 COURTNEY ST NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-3052
Country : US
Telephone Number : 616-209-8343
Fax Number :
Provider Business Practice Location Address
First Line : 1031 COURTNEY ST NW
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49504-3052
Country : US
Telephone Number : 616-209-8343
Fax Number :
Authorized Official
Title or Position : CEO/THERAPIST
Name : JENNIFER BARAJAS
Credential : MS, LPC
Telephone Number : 616-209-8343
Provider Enumeration Date : 03/06/2020
Last Update Date : 11/27/2023

Similar Medicare Providers

1801027941 — MS. JENNIFER A BARAJAS MS, LPC
Practice Location Address:
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Practice Fax: 616-732-6391
1841294410 — SUSAN M PHILLIPS M.D
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1558365163 — BRIAN V PHILLIPS MD
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1982699476 — JOSHUA S BRINKS FNP
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1417945288 — STACIE L GRIEMSMAN MD
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1871562066 — ANGELA RENEE OOSTEMA MD
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Directions to “HOLISTIC THERAPEUTIC SERVICES, PLLC ” Practice Location

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