MEDICARE: JOYFUL SOUL COUNSELING, PLLC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477263572
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL SOUL COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	6901 S PIERCE ST STE 370
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-7202
Country	:	US
Telephone Number	:	720-515-6385
Fax Number	:

Provider Business Practice Location Address
First Line	:	6901 S PIERCE ST STE 370
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80128-7202
Country	:	US
Telephone Number	:	720-515-6385
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA L OLGUIN
Credential	:	LAC, LPC
Telephone Number	:	720-515-6385

Provider Enumeration Date	:	11/29/2022
Last Update Date	:	03/30/2023

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