MEDICARE: SOULGOOD HEALING LLC

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	:	1750264982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOULGOOD HEALING LLC

Provider Business Mailing Address
First Line	:	1 E BROAD ST STE 130-1260
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-5913
Country	:	US
Telephone Number	:	484-375-7477
Fax Number	:	484-375-7477

Provider Business Practice Location Address
First Line	:	1 E BROAD ST STE 130-1260
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-5913
Country	:	US
Telephone Number	:	484-375-7477
Fax Number	:	484-375-7477

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	DR. LYNETTE S LUCKERS
Credential	:	LPC
Telephone Number	:	484-375-7477

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	07/28/2025

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Directions to “SOULGOOD HEALING LLC ” Practice Location

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