Provider Demographics
NPI:1437580198
Name:HOLISTIC MENTAL HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HOLISTIC MENTAL HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CADIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:305-330-4550
Mailing Address - Street 1:PO BOX 343681
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33034-0681
Mailing Address - Country:US
Mailing Address - Phone:305-330-4550
Mailing Address - Fax:305-675-7882
Practice Address - Street 1:18710 SW 107TH AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6742
Practice Address - Country:US
Practice Address - Phone:305-330-4550
Practice Address - Fax:305-675-7882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW129161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty