Provider Demographics
NPI:1336751163
Name:HOLISTIC GROWTH INTEGRATIVE COUNSELING
Entity Type:Organization
Organization Name:HOLISTIC GROWTH INTEGRATIVE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER -CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:AIRES
Authorized Official - Last Name:RUST
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHC, CRC, IWLC
Authorized Official - Phone:808-824-0721
Mailing Address - Street 1:5306 SIX FORKS RD STE 213
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4468
Mailing Address - Country:US
Mailing Address - Phone:808-824-0721
Mailing Address - Fax:828-933-1134
Practice Address - Street 1:5306 SIX FORKS RD STE 213
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4468
Practice Address - Country:US
Practice Address - Phone:808-824-0721
Practice Address - Fax:828-933-1134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Single Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty
No225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance TherapistGroup - Single Specialty
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Single Specialty