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General NPI Number Information
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NPI Number | 1801686662
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Entity Type | Organization
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Legal Business Name | SOUL HAVEN COUNSELING, PLLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 2900 SPRING ARBOR RD STE 6
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City | JACKSON
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State | MI
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Zip | 49203-3610
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Country | US
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Telephone | 517-459-9158
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 SPRING ARBOR RD STE 6
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City | JACKSON
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State | MI
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Zip | 49203-3610
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Country | US
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Telephone | 517-459-9158
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | ALEXANDRA BRANKOVICH-ESHAM
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Credential | LPC
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Telephone | 517-459-9158
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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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