Healthcare Provider Details

I. General information

NPI: 1922832542
Provider Name (Legal Business Name): SOUL TIDE COUNSELING AND CONSULTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6265 RIVERSIDE DR STE 2S
DUBLIN OH
43017-5444
US

IV. Provider business mailing address

6265 RIVERSIDE DR STE 2S
DUBLIN OH
43017-5444
US

V. Phone/Fax

Practice location:
  • Phone: 513-507-4613
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALMAS MALIK
Title or Position: OWNER
Credential:
Phone: 513-507-4613