Provider Demographics
NPI:1659253060
Name:HEALING INSTITUTE OF GEORGIA, LLC
Entity type:Organization
Organization Name:HEALING INSTITUTE OF GEORGIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:478-501-0269
Mailing Address - Street 1:140 CULVER ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-3002
Mailing Address - Country:US
Mailing Address - Phone:478-501-0269
Mailing Address - Fax:
Practice Address - Street 1:140 CULVER ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-3002
Practice Address - Country:US
Practice Address - Phone:478-501-0269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)