Provider Demographics
NPI:1083352504
Name:THE HEALING PLACE OF LONOKE,INC DBA FREETTA NELSON HEMPHILL, LCSWHILL
Entity Type:Organization
Organization Name:THE HEALING PLACE OF LONOKE,INC DBA FREETTA NELSON HEMPHILL, LCSWHILL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FREETTA
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:HEMPHILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:518-248-0838
Mailing Address - Street 1:5001 CALICO CREEK CV
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-7635
Mailing Address - Country:US
Mailing Address - Phone:518-248-0838
Mailing Address - Fax:
Practice Address - Street 1:425 W BROADWAY ST STE J
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-5576
Practice Address - Country:US
Practice Address - Phone:518-248-0838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)