Provider Demographics
NPI:1104496678
Name:HEALING REFLECTIONS, PLLC
Entity type:Organization
Organization Name:HEALING REFLECTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:910-580-8280
Mailing Address - Street 1:350 SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-6237
Mailing Address - Country:US
Mailing Address - Phone:910-580-8280
Mailing Address - Fax:910-304-5633
Practice Address - Street 1:350 SHAW AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-6237
Practice Address - Country:US
Practice Address - Phone:910-580-8280
Practice Address - Fax:910-304-5633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-28
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCM148OtherPALMETTO GBA