Provider Demographics
NPI:1922858323
Name:SOTERIA COUNSELING
Entity Type:Organization
Organization Name:SOTERIA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:901-605-0768
Mailing Address - Street 1:1910 MADISON AVE # 3401
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-2620
Mailing Address - Country:US
Mailing Address - Phone:901-605-0768
Mailing Address - Fax:
Practice Address - Street 1:1455 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-2934
Practice Address - Country:US
Practice Address - Phone:901-605-0768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty