Healthcare Provider Details

I. General information

NPI: 1891505467
Provider Name (Legal Business Name): SOULFUL SOLUTIONS COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 LINDEN ST
SCRANTON PA
18510-2440
US

IV. Provider business mailing address

712 LINDEN ST
SCRANTON PA
18510-2440
US

V. Phone/Fax

Practice location:
  • Phone: 570-980-4340
  • Fax:
Mailing address:
  • Phone: 570-980-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. ALLYSON VILLELLA
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: LPC
Phone: 570-980-4340