Provider Demographics
NPI:1265103352
Name:THE WHOLISTIC INSTITUTE
Entity type:Organization
Organization Name:THE WHOLISTIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC-S, LCDC
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:817-875-5845
Mailing Address - Street 1:8328 EDGEPOINT TRL
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-7447
Mailing Address - Country:US
Mailing Address - Phone:817-875-5845
Mailing Address - Fax:844-318-2753
Practice Address - Street 1:2217 MARTIN DR STE 200
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6249
Practice Address - Country:US
Practice Address - Phone:817-537-2044
Practice Address - Fax:844-318-2753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX312929803Medicaid