MEDICARE: SOMA RELATIONAL 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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1841147493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOMA RELATIONAL COUNSELING PLLC

Provider Business Mailing Address
First Line	:	1380 JORDAN CT
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-7310
Country	:	US
Telephone Number	:	850-776-1300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1380 JORDAN CT
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-7310
Country	:	US
Telephone Number	:	850-776-1300
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMANTHA USI
Credential	:
Telephone Number	:	850-776-1300

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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