=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124973573
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE SOUL GARDEN COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2026
-----------------------------------------------------
Last Update Date | 03/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7223 PARCHMENT CIR
-----------------------------------------------------
City | RUTHER GLEN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22546-2975
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-841-1170
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7223 PARCHMENT CIR
-----------------------------------------------------
City | RUTHER GLEN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22546-2975
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-841-1170
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MENTAL HEALTH COUNSELOR
-----------------------------------------------------
Name | ELENA MERCEDES MORALES
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 540-841-1170
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------