Provider Demographics
NPI:1427794304
Name:JANNAH THERAPY & HEALING SERVICES LLC
Entity type:Organization
Organization Name:JANNAH THERAPY & HEALING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHAQ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-917-7531
Mailing Address - Street 1:2322 GOLDEN BAY LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2193
Mailing Address - Country:US
Mailing Address - Phone:404-917-7531
Mailing Address - Fax:
Practice Address - Street 1:2322 GOLDEN BAY LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2193
Practice Address - Country:US
Practice Address - Phone:404-917-7531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty