Provider Demographics
NPI:1508556945
Name:WHOLENESS CLINICAL MENTAL HEALTH SERVICES
Entity Type:Organization
Organization Name:WHOLENESS CLINICAL MENTAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-A
Authorized Official - Phone:956-459-4685
Mailing Address - Street 1:3665 OLD HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-9101
Mailing Address - Country:US
Mailing Address - Phone:956-801-2064
Mailing Address - Fax:
Practice Address - Street 1:3665 OLD HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-9101
Practice Address - Country:US
Practice Address - Phone:956-801-2064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty