Provider Demographics
NPI:1902438567
Name:HEALING GROUNDS THERAPY AND WELLNESS CENTER
Entity Type:Organization
Organization Name:HEALING GROUNDS THERAPY AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAVARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CAMS
Authorized Official - Phone:770-558-7956
Mailing Address - Street 1:35 PULASKI AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-6416
Mailing Address - Country:US
Mailing Address - Phone:770-558-7956
Mailing Address - Fax:
Practice Address - Street 1:1702 HUDSON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-6387
Practice Address - Country:US
Practice Address - Phone:770-558-7956
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty