Provider Demographics
NPI:1598370629
Name:PEACEFUL HEALING SOUL COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:PEACEFUL HEALING SOUL COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER, OWNER, MENTAL HEALTH COUNS
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-240-7797
Mailing Address - Street 1:130 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4371
Mailing Address - Country:US
Mailing Address - Phone:774-240-7797
Mailing Address - Fax:508-510-6538
Practice Address - Street 1:ONLINE THERAPY
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127
Practice Address - Country:US
Practice Address - Phone:774-240-7797
Practice Address - Fax:508-510-6538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty