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General NPI Number Information
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NPI Number | 1679284335
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Entity Type | Organization
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Legal Business Name | HEART AND SOUL COUNSELING
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Dates
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Enumeration Date | 12/13/2022
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 7005 N LAKE BLVD # 166
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City | TAHOE VISTA
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State | CA
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Zip | 96148-9800
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Country | US
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Telephone | 619-540-4111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 166
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City | TAHOE VISTA
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State | CA
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Zip | 96148-0166
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Country | US
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Telephone | 619-540-4111
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Fax | 530-494-0204
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Authorized Official
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Title or Position | OWNER
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Name | KEINA LINEBARGER
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Credential | LMFT
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Telephone | 619-540-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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