Healthcare Provider Details

I. General information

NPI: 1245381672
Provider Name (Legal Business Name): RICHARD FRANCIS SOULE LICENSE SOCIAL WORKE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 E 3RD ST
ERIE PA
16507-1753
US

IV. Provider business mailing address

3921 STELLAR DR
ERIE PA
16506-4728
US

V. Phone/Fax

Practice location:
  • Phone: 814-878-4939
  • Fax:
Mailing address:
  • Phone: 814-835-0358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberSW008789L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW008789L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: