Provider Demographics
NPI:1215536453
Name:COLLABORATIVE HEALING COUNSELING
Entity Type:Organization
Organization Name:COLLABORATIVE HEALING COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:MED, ALC, NCC
Authorized Official - Phone:205-315-9937
Mailing Address - Street 1:1641 KESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-2349
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1641 KESTWICK DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-2349
Practice Address - Country:US
Practice Address - Phone:205-315-9937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)