Healthcare Provider Details

I. General information

NPI: 1194645226
Provider Name (Legal Business Name): LE SOUL ATELIER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 WILSHIRE BLVD STE P04-1935
LOS ANGELES CA
90010-2707
US

IV. Provider business mailing address

PO BOX 5066
BELLFLOWER CA
90707-5066
US

V. Phone/Fax

Practice location:
  • Phone: 323-798-9602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHAREE JOHNSON
Title or Position: OWNER
Credential: LCSW
Phone: 562-367-9266