Provider Demographics
NPI:1164180899
Name:HOLISTIC RECOVERY
Entity Type:Organization
Organization Name:HOLISTIC RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:781-264-3859
Mailing Address - Street 1:28 SAUNDERS RD
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01904-1571
Mailing Address - Country:US
Mailing Address - Phone:781-264-3859
Mailing Address - Fax:
Practice Address - Street 1:28 SAUNDERS RD
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-1571
Practice Address - Country:US
Practice Address - Phone:781-264-3859
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty