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General NPI Number Information
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NPI Number | 1598605222
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Entity Type | Organization
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Legal Business Name | SACRED SOUL, LLC
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 5150 W EXPO PKWY APT M-203
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 509-818-9964
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 W EXPO PKWY APT M-203
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City | POST FALLS
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State | ID
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Zip | 83815
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Country | US
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Telephone | 509-818-9964
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KRISTIN OPRIS
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Credential | LCPC
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Telephone | 509-818-9964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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