Provider Demographics
NPI:1750850723
Name:SOMA RECOVERY LLC
Entity type:Organization
Organization Name:SOMA RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:HELMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:770-715-4772
Mailing Address - Street 1:825 N WACO AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3939
Mailing Address - Country:US
Mailing Address - Phone:316-201-6047
Mailing Address - Fax:
Practice Address - Street 1:825 N WACO AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3939
Practice Address - Country:US
Practice Address - Phone:316-201-6047
Practice Address - Fax:316-221-7157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty