Provider Demographics
NPI:1932079894
Name:SOUL PATH THERAPY, PLLC
Entity type:Organization
Organization Name:SOUL PATH THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANADAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-517-2773
Mailing Address - Street 1:3419 VIRGINIA BEACH BLVD # 633
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4419
Mailing Address - Country:US
Mailing Address - Phone:757-517-2773
Mailing Address - Fax:
Practice Address - Street 1:8401 MARYLAND DRIVE
Practice Address - Street 2:SUITE A #6403
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294
Practice Address - Country:US
Practice Address - Phone:757-517-2773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA601405559Medicaid