Organization Active NPI

Holistic Healing Therapy LLC

  • Clinical Social Worker
  • Dearborn, MI
National Provider Identifier
1326721002
Registry record updated Aug 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
HOLISTIC HEALING THERAPY LLC
Practice address
6642 Theisen St
Dearborn, MI 48126-1984
Phone
(313) 414-3093
NPI assigned
Aug 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2024

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

Authorized official

Name
Fatme Ancouni
Title
Clinical Social Worker
Phone
(313) 414-3093

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

6642 Theisen St
Dearborn, MI 48126-1984

Mailing address

6642 Theisen St
Dearborn, MI 48126-1984
Phone (313) 414-3093

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1326721002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6642 THEISEN ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261984",
            "telephone_number": "313-414-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6642 THEISEN ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261984",
            "telephone_number": "313-414-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HEALING THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-09",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "ANCOUNI",
        "authorized_official_first_name": "FATME",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "313-414-3093"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.