| Soul Fed Therapy And Consulting Pllc | |
|
2832 Sw 41st St Oklahoma City OK 73119-3323 | |
| (918) 671-8229 | |
| Not Available |
| Full Name | Soul Fed Therapy And Consulting Pllc |
|---|---|
| Speciality | Counselor |
| Location | 2832 Sw 41st St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Julie Marie Burnshire (THERAPIST) |
| Authorized Official Contact | 4054370755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Fed Therapy And Consulting Pllc Po Box 1926 Oklahoma City OK 73101-1926 Ph: () - | Soul Fed Therapy And Consulting Pllc 2832 Sw 41st St Oklahoma City OK 73119-3323 Ph: (918) 671-8229 |
| NPI Number | 1952089328 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 10/21/2024 |
| Certification Date | 10/21/2024 |
| Medicare PECOS PAC ID | 4789039041 |
|---|---|
| Medicare Enrollment ID | O20231006002015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952089328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Julie Marie Burnshire |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720355787 PECOS PAC ID: 1557684008 Enrollment ID: I20150108001154 |
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