Provider Demographics
NPI:1750709556
Name:AN INSTRUMENT OF HEALING AND PEACE
Entity type:Organization
Organization Name:AN INSTRUMENT OF HEALING AND PEACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:850-830-5904
Mailing Address - Street 1:927 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-2707
Mailing Address - Country:US
Mailing Address - Phone:850-830-5904
Mailing Address - Fax:850-279-3076
Practice Address - Street 1:4591 E HIGHWAY 20 STE 202I
Practice Address - Street 2:
Practice Address - City:NICEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32578-8844
Practice Address - Country:US
Practice Address - Phone:850-830-5904
Practice Address - Fax:850-279-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2476106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty