Provider Demographics
NPI:1518689124
Name:SOUL CARE COUNSELING AND CONSULTING, LLC
Entity Type:Organization
Organization Name:SOUL CARE COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:208-550-0450
Mailing Address - Street 1:1001 HUNTINGTON CT
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-5589
Mailing Address - Country:US
Mailing Address - Phone:208-960-5711
Mailing Address - Fax:
Practice Address - Street 1:101 11TH AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3918
Practice Address - Country:US
Practice Address - Phone:208-960-5711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty