Healthcare Provider Details

I. General information

NPI: 1992666804
Provider Name (Legal Business Name): SOUL CRAFT INDIVIDUAL AND MARRIAGE COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E MAIN ST STE 350
GRASS VALLEY CA
95945-5853
US

IV. Provider business mailing address

PO BOX 3512
GRASS VALLEY CA
95945-3500
US

V. Phone/Fax

Practice location:
  • Phone: 530-362-4163
  • Fax:
Mailing address:
  • Phone: 530-362-4163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CANDICE CRAFT
Title or Position: OWNER
Credential: LMFT
Phone: 530-362-4163