Provider Demographics
NPI:1881376044
Name:SOUL JOURNEY COUNSELING PC
Entity type:Organization
Organization Name:SOUL JOURNEY COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:347-933-2583
Mailing Address - Street 1:181 HAWTHORNE ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-5827
Mailing Address - Country:US
Mailing Address - Phone:347-933-2583
Mailing Address - Fax:
Practice Address - Street 1:181 HAWTHORNE ST APT 2E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-5827
Practice Address - Country:US
Practice Address - Phone:347-933-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty