| Soul Counseling, Pllc | |
|
201 W Springfield Ave Ste 1008 Champaign IL 61820-6385 | |
| (217) 607-2020 | |
| (217) 607-2020 |
| Full Name | Soul Counseling, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 201 W Springfield Ave Ste 1008, Champaign, Illinois |
| Authorized Official Name and Position | Fida Abdelrasoul (CLINICAL THERAPIST/OWNER) |
| Authorized Official Contact | 7577522073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Counseling, Pllc 3905 Daffodil Ln Champaign IL 61822-2031 Ph: (757) 752-2073 | Soul Counseling, Pllc 201 W Springfield Ave Ste 1008 Champaign IL 61820-6385 Ph: (217) 607-2020 |
| NPI Number | 1932825122 |
|---|---|
| Provider Enumeration Date | 10/18/2022 |
| Last Update Date | 10/18/2022 |
| Certification Date | 10/18/2022 |
| Medicare PECOS PAC ID | 1850760943 |
|---|---|
| Medicare Enrollment ID | O20221212002925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932825122 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Fida Abdelrasoul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669021010 PECOS PAC ID: 4486058328 Enrollment ID: I20210813002115 |
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