Healthcare Provider Details

I. General information

NPI: 1952819138
Provider Name (Legal Business Name): SOUL CARE COUNSELING AND CONSULTING. PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 01/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 MOUNT OLIVE ESTATES DR
MT PLEASANT NC
28124-9625
US

IV. Provider business mailing address

10535 MOUNT OLIVE ESTATES DR
MT PLEASANT NC
28124-9625
US

V. Phone/Fax

Practice location:
  • Phone: 701-610-8454
  • 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: STEPHANIE SOULIES
Title or Position: OWNER/ MENTAL HEALTH COUNSELOR
Credential:
Phone: 701-610-8454