MEDICARE: TENDING TO THE SOUL COLLECTIVE

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1861351348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TENDING TO THE SOUL COLLECTIVE

Provider Business Mailing Address
First Line	:	3553 ATLANTIC AVE # 168
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-5606
Country	:	US
Telephone Number	:	901-235-3449
Fax Number	:

Provider Business Practice Location Address
First Line	:	3553 ATLANTIC AVE # 168
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-5606
Country	:	US
Telephone Number	:	901-235-3449
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	SAMUEL JOHN KLEIST
Credential	:	ASW
Telephone Number	:	901-235-3449

Provider Enumeration Date	:	01/20/2026
Last Update Date	:	01/20/2026

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Directions to “TENDING TO THE SOUL COLLECTIVE ” Practice Location

Language	Start Address	Practice Location

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