MEDICARE: INTENSIFY THE SOUL

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1508696733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTENSIFY THE SOUL

Provider Business Mailing Address
First Line	:	2950 VAN NESS ST NW APT 928
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1120
Country	:	US
Telephone Number	:	919-827-5545
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 VAN NESS ST NW APT 928
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1120
Country	:	US
Telephone Number	:	919-827-5545
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAKISHA WOMACK
Credential	:
Telephone Number	:	919-827-5545

Provider Enumeration Date	:	08/02/2024
Last Update Date	:	02/05/2026

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Directions to “INTENSIFY THE SOUL ” Practice Location

Language	Start Address	Practice Location

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