Healthcare Provider Details

I. General information

NPI: 1356262612
Provider Name (Legal Business Name): SOMA ATHENE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SANDBAR RD APT D
WINDHAM ME
04062-5796
US

IV. Provider business mailing address

50 SANDBAR RD APT D
WINDHAM ME
04062-5796
US

V. Phone/Fax

Practice location:
  • Phone: 828-619-0081
  • Fax: 207-893-8959
Mailing address:
  • Phone: 828-619-0081
  • Fax: 207-893-8959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES SKELTON
Title or Position: OWNER / THERAPIST
Credential: LCSW
Phone: 207-955-6222