Provider Demographics
NPI:1972250173
Name:GOLD SOUL COUNSELING LLC
Entity Type:Organization
Organization Name:GOLD SOUL COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:G
Authorized Official - Last Name:PELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-699-2866
Mailing Address - Street 1:2011 DILLON DR NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-2473
Mailing Address - Country:US
Mailing Address - Phone:505-699-2866
Mailing Address - Fax:
Practice Address - Street 1:1740 GRANDE BLVD SE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1799
Practice Address - Country:US
Practice Address - Phone:505-699-2866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty