Provider Demographics
NPI:1780335018
Name:SOUL COUNSELING SERVICES
Entity type:Organization
Organization Name:SOUL COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GORDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-213-5338
Mailing Address - Street 1:231 E ALESSANDRO BLVD # 6A138
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92508-5084
Mailing Address - Country:US
Mailing Address - Phone:951-422-3035
Mailing Address - Fax:
Practice Address - Street 1:231 E ALESSANDRO BLVD # 6A138
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92508-5084
Practice Address - Country:US
Practice Address - Phone:951-422-3035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty