| Soul-renity, Llc | |
|
1601 Saint Paul St 2nd Floor Baltimore MD 21202-4871 | |
| (410) 921-9800 | |
| (410) 928-4222 |
| Full Name | Soul-renity, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1601 Saint Paul St, Baltimore, Maryland |
| Authorized Official Name and Position | Kier Michelle Johnson (PSYCHOTHERAPIST) |
| Authorized Official Contact | 4109219800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul-renity, Llc 1601 Saint Paul St 2nd Floor Baltimore MD 21202-4871 Ph: (410) 921-9800 | Soul-renity, Llc 1601 Saint Paul St 2nd Floor Baltimore MD 21202-4871 Ph: (410) 921-9800 |
| NPI Number | 1962849133 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 05/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962849133 | NPI | - | NPPES |
| 304800400 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC2447 (Maryland) | Primary |
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