Provider Demographics
NPI:1659124865
Name:SOFT EDGE COUNSELING SERVICES PLLC
Entity Type:Organization
Organization Name:SOFT EDGE COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:MAYES
Authorized Official - Last Name:GRIPPO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:603-714-5109
Mailing Address - Street 1:1300 SAINT JAMES PL
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1170
Mailing Address - Country:US
Mailing Address - Phone:603-714-5109
Mailing Address - Fax:
Practice Address - Street 1:1300 SAINT JAMES PL
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1170
Practice Address - Country:US
Practice Address - Phone:603-714-5109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty