Healthcare Provider Details

I. General information

NPI: 1174450258
Provider Name (Legal Business Name): REBECCA SOULE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 MOREHOUSE ROAD
EASTON CT
06612
US

IV. Provider business mailing address

PO BOX 274
EASTON CT
06612-0274
US

V. Phone/Fax

Practice location:
  • Phone: 203-646-3373
  • Fax:
Mailing address:
  • Phone: 203-646-3373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number009582
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: