| Soul Care, Pllc | |
|
5501 Executive Center Dr Ste 215 Charlotte NC 28212-8823 | |
| (980) 613-8312 | |
| (888) 972-4998 |
| Full Name | Soul Care, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 5501 Executive Center Dr Ste 215, Charlotte, North Carolina |
| Authorized Official Name and Position | Chantelle M. Johnson (CLINICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 9806138312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Care, Pllc 3695 Sunset Ave Unit 8936 Rocky Mount NC 27804-0286 Ph: (980) 613-8312 | Soul Care, Pllc 5501 Executive Center Dr Ste 215 Charlotte NC 28212-8823 Ph: (980) 613-8312 |
| NPI Number | 1821320334 |
|---|---|
| Provider Enumeration Date | 02/08/2010 |
| Last Update Date | 11/22/2021 |
| Certification Date | 11/22/2021 |
| Medicare PECOS PAC ID | 8224329008 |
|---|---|
| Medicare Enrollment ID | O20160627000191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821320334 | NPI | - | NPPES |
| Provider Name | Andrea Denise Symes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467989368 PECOS PAC ID: 2668703612 Enrollment ID: I20191007001119 |
| Provider Name | Quintisha L China |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093379232 PECOS PAC ID: 0941653224 Enrollment ID: I20240202001637 |
| Provider Name | Jeff Helms |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700335650 PECOS PAC ID: 7113361817 Enrollment ID: I20240221002959 |
| Provider Name | Chantelle M Johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841520590 PECOS PAC ID: 3779874557 Enrollment ID: I20240222002451 |
| Provider Name | Nakina N Scott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629616982 PECOS PAC ID: 0446695613 Enrollment ID: I20240227003051 |
| Provider Name | William Darrisaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386015071 PECOS PAC ID: 8123463734 Enrollment ID: I20240305001044 |
| Provider Name | Janet S Oliver |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073707402 PECOS PAC ID: 2163869231 Enrollment ID: I20240325002766 |
| Provider Name | Anthony T Redfearn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518303833 PECOS PAC ID: 1456798222 Enrollment ID: I20240328002259 |
| Provider Name | James H Nance |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841853124 PECOS PAC ID: 9436596228 Enrollment ID: I20240328002748 |
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