Provider Demographics
NPI:1992395263
Name:THE HEALING SPOT
Entity Type:Organization
Organization Name:THE HEALING SPOT
Other - Org Name:SERENITY WELLNESS CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:IVIE-WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:740-538-8363
Mailing Address - Street 1:3255 JODECO PL
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-5352
Mailing Address - Country:US
Mailing Address - Phone:678-517-6423
Mailing Address - Fax:
Practice Address - Street 1:1445 WOODMONT LN NW # 887
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2866
Practice Address - Country:US
Practice Address - Phone:740-538-8363
Practice Address - Fax:866-422-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty