Provider Demographics
NPI:1194413096
Name:ARC OF HEALING THERAPY SERVICES
Entity type:Organization
Organization Name:ARC OF HEALING THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHRISHANDALYN
Authorized Official - Middle Name:RATIONNE
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-BACS
Authorized Official - Phone:337-577-0937
Mailing Address - Street 1:4875 S SHERWOOD FOREST BLVD STE D1
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4640
Mailing Address - Country:US
Mailing Address - Phone:225-512-4669
Mailing Address - Fax:833-222-8840
Practice Address - Street 1:4875 S SHERWOOD FOREST BLVD STE D1
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4640
Practice Address - Country:US
Practice Address - Phone:225-512-4669
Practice Address - Fax:833-222-8840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-27
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty