Provider Demographics
NPI:1265807903
Name:HEALING SPIRIT COUNSELING SERVICE LLC
Entity type:Organization
Organization Name:HEALING SPIRIT COUNSELING SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:PUTMAN
Authorized Official - Last Name:TWITTY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-665-2457
Mailing Address - Street 1:287 COUNTY ROAD 175
Mailing Address - Street 2:
Mailing Address - City:IUKA
Mailing Address - State:MS
Mailing Address - Zip Code:38852
Mailing Address - Country:US
Mailing Address - Phone:662-665-2457
Mailing Address - Fax:662-423-3331
Practice Address - Street 1:629 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:IUKA
Practice Address - State:MS
Practice Address - Zip Code:38852-8201
Practice Address - Country:US
Practice Address - Phone:662-665-2457
Practice Address - Fax:662-423-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1116251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health