| Soulistic Counseling Corner, Llc | |
|
415 N Richard Jackson Blvd Ste 204 Panama City Beach FL 32407-3694 | |
| (850) 628-1956 | |
| Not Available |
| Full Name | Soulistic Counseling Corner, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 415 N Richard Jackson Blvd Ste 204, Panama City Beach, Florida |
| Authorized Official Name and Position | Shae Nicole Luster (COUNSELOR/OWNER) |
| Authorized Official Contact | 8506281956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulistic Counseling Corner, Llc 415 N Richard Jackson Blvd Ste 204 Panama City Beach FL 32407-3694 Ph: (850) 628-1956 | Soulistic Counseling Corner, Llc 415 N Richard Jackson Blvd Ste 204 Panama City Beach FL 32407-3694 Ph: (850) 628-1956 |
| NPI Number | 1972082121 |
|---|---|
| Provider Enumeration Date | 08/08/2018 |
| Last Update Date | 08/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972082121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH13989 (Florida) | Primary |
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