| The Integrated Soul, Llc | |
|
2501 Chatham Rd Ste 4520 Springfield IL 62704-4188 | |
| (773) 808-6033 | |
| Not Available |
| Full Name | The Integrated Soul, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2501 Chatham Rd Ste 4520, Springfield, Illinois |
| Authorized Official Name and Position | Paula Rucci Voigt (PRESIDENT & CLINICIAN) |
| Authorized Official Contact | 6307431983 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Integrated Soul, Llc 2501 Chatham Rd Ste 4520 Springfield IL 62704-4188 Ph: (773) 808-6033 | The Integrated Soul, Llc 2501 Chatham Rd Ste 4520 Springfield IL 62704-4188 Ph: (773) 808-6033 |
| NPI Number | 1356029045 |
|---|---|
| Provider Enumeration Date | 07/11/2023 |
| Last Update Date | 07/11/2023 |
| Certification Date | 07/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356029045 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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