| Soul Garden Counseling Llc | |
|
1953 Ketegawn Rd Owosso MI 48867-1529 | |
| (720) 220-8106 | |
| Not Available |
| Full Name | Soul Garden Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1953 Ketegawn Rd, Owosso, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Garden Counseling Llc 1953 Ketegawn Rd Owosso MI 48867-1529 Ph: () - | Soul Garden Counseling Llc 1953 Ketegawn Rd Owosso MI 48867-1529 Ph: (720) 220-8106 |
| NPI Number | 1073228805 |
|---|---|
| Provider Enumeration Date | 01/17/2023 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 0648614164 |
|---|---|
| Medicare Enrollment ID | O20240222003133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073228805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Kendra Docker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699316976 PECOS PAC ID: 1557705076 Enrollment ID: I20240222003213 |
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