Healthcare Provider Details

I. General information

NPI: 1457287492
Provider Name (Legal Business Name): SOUL SOLUTIONS PSYCHIATRIC & COUNSELING SERVICES, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 3RD ST NW STE 208
WINTER HAVEN FL
33881-4094
US

IV. Provider business mailing address

7623 STATE ROAD 653
WINTER HAVEN FL
33884-3472
US

V. Phone/Fax

Practice location:
  • Phone: 863-364-4711
  • Fax: 863-875-2001
Mailing address:
  • Phone: 863-364-4711
  • Fax: 863-875-2001

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: MIRTHA ALVAREZ ACEVEDO
Title or Position: OWNER-CMO
Credential: AGPCNP-BC, PMHNP-BC
Phone: 863-364-4711