Mindful Healing Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MINDFUL HEALING THERAPY

Practice address

101 Rhonda Ann PL
Hot Springs, AR 71909-9645

Phone

(501) 500-4091

Fax

(501) 307-1475

NPI assigned

Aug 28, 2023

Last updated

Feb 21, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Holly De Sambourg, LCSWNPI 1811480320

Title

Mental Health Therapist

Phone

(501) 500-4091

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Holly J De Sambourg, LCSW

  • Clinical Social Worker
  • Hot Springs, AR
  • NPI 1811480320
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1396520458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RHONDA ANN PL",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719099645",
            "telephone_number": "501-463-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RHONDA ANN PL",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "719099645",
            "telephone_number": "501-500-4091",
            "fax_number": "501-307-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL HEALING THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "DE SAMBOURG",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "MENTAL HEALTH THERAPIST",
        "authorized_official_telephone_number": "501-500-4091",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Miller, PHARMD
• Jeffrey James Miller, MD
• Sara Miller, OTR/L
• Susan L Millerd, LCSW
• Mind Body and Soul Therapeutic Services LLC
• Lacy McHenry Minge, PHARMD
• Thomas E. Minnich, M.D.
• Erica Minyard
• Katherine Miser
• Miss Idas House of Care & Love

• Clinical Social Worker in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.