Healthcare Provider Details

I. General information

NPI: 1679057491
Provider Name (Legal Business Name): SOUL SONG COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 S CLARKSON ST STE 222
DENVER CO
80210-1627
US

IV. Provider business mailing address

1001 E BAYAUD AVE APT 1603
DENVER CO
80209-2385
US

V. Phone/Fax

Practice location:
  • Phone: 303-929-4906
  • Fax:
Mailing address:
  • Phone: 303-929-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA HART
Title or Position: OWNER/THERAPIST
Credential: LPC
Phone: 303-929-4906