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General NPI Number Information
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NPI Number | 1144813379
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Entity Type | Organization
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Legal Business Name | PEACEFUL SOUL HEALING, PLLC
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Dates
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Enumeration Date | 02/18/2021
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Last Update Date | 02/18/2021
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Provider Practice Location Address
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Address Line | 1728 E MADISON ST
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City | SEATTLE
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State | WA
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Zip | 98122-2733
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Country | US
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Telephone | 206-487-3880
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Fax |
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Provider Business Mailing Address
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Address Line | 4046 NE 55TH ST UNIT A
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City | SEATTLE
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State | WA
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Zip | 98105-2266
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Country | US
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Telephone | 206-612-3353
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | SIMA KULSHRESHTHA
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Credential | LICSW
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Telephone | 206-487-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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