Provider Demographics
NPI:1225704620
Name:HOLISTIC HARBOR PSYCHOTHERAPY AND WELLNESS, INC.
Entity Type:Organization
Organization Name:HOLISTIC HARBOR PSYCHOTHERAPY AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER / PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:KALVERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-687-2353
Mailing Address - Street 1:2300 HENDERSON MILL RD NE STE 310
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2704
Mailing Address - Country:US
Mailing Address - Phone:678-687-2353
Mailing Address - Fax:
Practice Address - Street 1:2300 HENDERSON MILL RD NE STE 310
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-2704
Practice Address - Country:US
Practice Address - Phone:678-687-2353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty