MEDICARE: ENLIGHTENED SOULS, LLC

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	101YM0800X	Mental Health 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	:	1922833706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENLIGHTENED SOULS, LLC

Provider Business Mailing Address
First Line	:	822 FRANKLIN AVE
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-2725
Country	:	US
Telephone Number	:	614-432-3165
Fax Number	:

Provider Business Practice Location Address
First Line	:	822 FRANKLIN AVE
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-2725
Country	:	US
Telephone Number	:	614-432-3165
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MRS. MELISSA DOLIN
Credential	:
Telephone Number	:	614-432-3165

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	03/04/2026

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Directions to “ENLIGHTENED SOULS, LLC ” Practice Location

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