Provider Demographics
NPI:1609763770
Name:THE SOMA COLLECTIVE
Entity type:Organization
Organization Name:THE SOMA COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:APRIL
Authorized Official - Last Name:DAIDONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-226-6179
Mailing Address - Street 1:543 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2816
Mailing Address - Country:US
Mailing Address - Phone:847-226-6179
Mailing Address - Fax:847-226-6179
Practice Address - Street 1:119 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2320
Practice Address - Country:US
Practice Address - Phone:847-226-6179
Practice Address - Fax:847-226-6179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty