| Healing Minds Therapeutic Services, Pllc | |
|
4140 Ramsey St Ste 108 Fayetteville NC 28311-7658 | |
| (910) 580-9346 | |
| (910) 229-3622 |
| Full Name | Healing Minds Therapeutic Services, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 4140 Ramsey St Ste 108, Fayetteville, North Carolina |
| Authorized Official Name and Position | Johnny Leonard (MANAGER/THERAPIST) |
| Authorized Official Contact | 9104890429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Minds Therapeutic Services, Pllc 5524 Bear Creek Cir Fayetteville NC 28304-4899 Ph: (910) 489-0429 | Healing Minds Therapeutic Services, Pllc 4140 Ramsey St Ste 108 Fayetteville NC 28311-7658 Ph: (910) 580-9346 |
| NPI Number | 1396262085 |
|---|---|
| Provider Enumeration Date | 08/24/2017 |
| Last Update Date | 07/11/2022 |
| Certification Date | 06/29/2022 |
| Medicare PECOS PAC ID | 1850737412 |
|---|---|
| Medicare Enrollment ID | O20240306001999 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396262085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 2305 (North Carolina) | Secondary |
| 101YP2500X | Counselor - Professional | 9092 (North Carolina) | Primary |
| Provider Name | Johnny D Leonard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407132079 PECOS PAC ID: 2769828326 Enrollment ID: I20240306002072 |
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