MEDICARE: SOUL RESTORATIONS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1053964312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUL RESTORATIONS, PLLC

Provider Business Mailing Address
First Line	:	784 S CLEARWATER LOOP STE 8049
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-9599
Country	:	US
Telephone Number	:	206-317-1200
Fax Number	:	206-316-8399

Provider Business Practice Location Address
First Line	:	784 S CLEARWATER LOOP STE 8049
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-9599
Country	:	US
Telephone Number	:	206-317-1200
Fax Number	:	206-316-8399

Authorized Official
Title or Position	:	MENTAL HEALTH THERAPIST
Name	:	LISA J PIERCE
Credential	:	MA, LMHC, LCPC
Telephone Number	:	206-317-1200

Provider Enumeration Date	:	07/16/2019
Last Update Date	:	03/17/2026

Similar Medicare Providers

1720502677 — MR. RAFAEL DAVID PENA PTA
Practice Location Address:

2871 POST RD , PREHAB SPORTS MEDICARE SERVICES INC.
WARWICK, RI
02886-0076

Practice Phone: 401-463-3060
Practice Fax: 401-732-1045

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1376905166 — ERICA ALAYNE BALCH LCSW
Practice Location Address:

784 S CLEARWATER LOOP STE R
POST FALLS, ID
83854-9599

Practice Phone: 208-295-2858
Practice Fax:

1801416813 — DR. RAMSEY A SAMY PHARMD
Practice Location Address:

784 S CLEARWATER LOOP STE B
POST FALLS, ID
83854-9599

Practice Phone: 201-788-9004
Practice Fax: 208-216-0205

1457207573 — CYTI HEALTH PROVIDERS PC
Practice Location Address:

784 S CLEARWATER LOOP STE B
POST FALLS, ID
83854-9599

Practice Phone: 866-478-3978
Practice Fax: 866-473-0365

1629604319 — IVONNE OLAY BOUJAOUDE
Practice Location Address:

784 S CLEARWATER LOOP STE 8075
POST FALLS, ID
83854-9599

Practice Phone: 208-808-4222
Practice Fax:

Directions to “SOUL RESTORATIONS, PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.