Whole Soul Healing Inc

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WHOLE SOUL HEALING INC

Practice address

4909 Hunter Village Dr
Ooltewah, TN 37363-9056

Phone

(732) 693-4008

NPI assigned

Jun 24, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amanda Fresnics, LCSW

Title

Owner/Therapist

Phone

(732) 693-4008

Specialties & licenses 1

Addresses

Other names 1

• Whole Soul Healing LLC Former legal business name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Ashley Kelly, MSW, LCSW

  • Clinical Social Worker
  • West Long Branch, NJ
  • NPI 1689153843
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1003485913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4909 HUNTER VILLAGE DR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639056",
            "telephone_number": "732-693-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4909 HUNTER VILLAGE DR",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373639056",
            "telephone_number": "732-693-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE SOUL HEALING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-01",
        "status": "A",
        "authorized_official_last_name": "FRESNICS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "732-693-4008",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whole Soul Healing LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Whole Soul Healing LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Keisha Lee Westmoreland, RN
• Kristen Whaley, OTR/L
• Bryan Jacob Wheat
• Hannah Elizabeth White, BSN, FNP-BC
• Kenia White, LMSW, LCSWA
• Cassie Ann Williams, FNP
• Terry Lee Williams Jr., D.O.
• Jeffrey Lynn Wilson, FNP-BC
• Rhonda Wilson, LPC-MHSP
• Cheryl Lynn Wiltse, O.D.

• Adult Mental Health Clinic/Center in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Adult Mental Health Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.