Provider Demographics
NPI:1902204639
Name:THE HEALING COLLECTIVE, LLC
Entity Type:Organization
Organization Name:THE HEALING COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:WHITAKER
Authorized Official - Last Name:TOLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:864-276-1788
Mailing Address - Street 1:5240 NORWAY LN
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-8398
Mailing Address - Country:US
Mailing Address - Phone:864-276-1788
Mailing Address - Fax:
Practice Address - Street 1:115 STONE VILLAGE DR STE E
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6489
Practice Address - Country:US
Practice Address - Phone:803-216-1604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-11
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC106951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty