Healthcare Provider Details

I. General information

NPI: 1033631783
Provider Name (Legal Business Name): SOULSHINE COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2017
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 GARRISON WOODS LN
WALLKILL NY
12589-4040
US

IV. Provider business mailing address

324 GARRISON WOODS LN
WALLKILL NY
12589-4040
US

V. Phone/Fax

Practice location:
  • Phone: 845-913-6562
  • Fax: 845-522-8817
Mailing address:
  • Phone: 845-913-6562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0789131
License Number StateNY

VIII. Authorized Official

Name: KIMBERLEY MCGRATH SALAMONE
Title or Position: OWNER
Credential: LCSW-R
Phone: 845-913-6562