Healthcare Provider Details

I. General information

NPI: 1124973573
Provider Name (Legal Business Name): THE SOUL GARDEN COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7223 PARCHMENT CIR
RUTHER GLEN VA
22546-2975
US

IV. Provider business mailing address

7223 PARCHMENT CIR
RUTHER GLEN VA
22546-2975
US

V. Phone/Fax

Practice location:
  • Phone: 540-841-1170
  • Fax:
Mailing address:
  • Phone: 540-841-1170
  • 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: ELENA MERCEDES MORALES
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LPC
Phone: 540-841-1170