| Soul Mender, Llc | |
|
525 N Cascade Ave Ste 118 Colorado Springs CO 80903-3308 | |
| (719) 439-8335 | |
| Not Available |
| Full Name | Soul Mender, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 525 N Cascade Ave Ste 118, Colorado Springs, Colorado |
| Authorized Official Name and Position | Linda Murt (OWNER) |
| Authorized Official Contact | 7194398335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Mender, Llc 525 N Cascade Ave Ste 118 Colorado Springs CO 80903-3308 Ph: (719) 439-8335 | Soul Mender, Llc 525 N Cascade Ave Ste 118 Colorado Springs CO 80903-3308 Ph: (719) 439-8335 |
| NPI Number | 1891550935 |
|---|---|
| Provider Enumeration Date | 02/19/2024 |
| Last Update Date | 02/19/2024 |
| Certification Date | 02/17/2024 |
| Medicare PECOS PAC ID | 4880033141 |
|---|---|
| Medicare Enrollment ID | O20240418003842 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891550935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Linda Murt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326683079 PECOS PAC ID: 4183012479 Enrollment ID: I20211019000496 |
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