MEDICARE: SOUL CARE EMPOWERMENT INSTITUTE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1245187202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUL CARE EMPOWERMENT INSTITUTE, INC.

Provider Business Mailing Address
First Line	:	7 PROFESSIONAL PKWY STE 101
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-2648
Country	:	US
Telephone Number	:	601-781-1661
Fax Number	:	800-489-0211

Provider Business Practice Location Address
First Line	:	7 PROFESSIONAL PKWY STE 101
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-2648
Country	:	US
Telephone Number	:	601-781-1661
Fax Number	:	800-489-0211

Authorized Official
Title or Position	:	CEO/EXECUTIVE DIRECTOR
Name	:	DR. ELIZABETH CONERLY SMITH
Credential	:	PHD, LPC. BCTMH
Telephone Number	:	601-402-4139

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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