Provider Demographics
NPI:1942616735
Name:HEALING TREE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:HEALING TREE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:NADINE
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-849-9463
Mailing Address - Street 1:979 GLENWOOD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1815
Mailing Address - Country:US
Mailing Address - Phone:404-600-8859
Mailing Address - Fax:404-600-8859
Practice Address - Street 1:979 GLENWOOD AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-1815
Practice Address - Country:US
Practice Address - Phone:404-600-8859
Practice Address - Fax:404-600-8859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0050611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty