| Soul Purpose Wellness Center, Llc | |
|
1318 Stone St Jonesboro AR 72401-4522 | |
| (501) 213-1330 | |
| (501) 421-2135 |
| Full Name | Soul Purpose Wellness Center, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1318 Stone St, Jonesboro, Arkansas |
| Authorized Official Name and Position | Katrina Adams (OWNER AND THERAPIST) |
| Authorized Official Contact | 5012131330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Purpose Wellness Center, Llc 1318 Stone St Jonesboro AR 72401-4522 Ph: (501) 213-1330 | Soul Purpose Wellness Center, Llc 1318 Stone St Jonesboro AR 72401-4522 Ph: (501) 213-1330 |
| NPI Number | 1538881255 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 03/13/2024 |
| Certification Date | 03/13/2024 |
| Medicare PECOS PAC ID | 8426425000 |
|---|---|
| Medicare Enrollment ID | O20221111000072 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538881255 | NPI | - | NPPES |
| 277740719 | Medicaid | AR | |
| 290450744 | Medicaid | AR |
| Provider Name | Katrina Renae Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821440181 PECOS PAC ID: 5092104919 Enrollment ID: I20211116000732 |
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