Provider Demographics
NPI:1932847308
Name:A SOUL AWAKE PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:A SOUL AWAKE PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:BARR
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC, LMHC, NCC
Authorized Official - Phone:425-270-7327
Mailing Address - Street 1:5230 39TH AVE S # 418
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6236
Mailing Address - Country:US
Mailing Address - Phone:425-270-7327
Mailing Address - Fax:
Practice Address - Street 1:5230 39TH AVE S # 418
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6236
Practice Address - Country:US
Practice Address - Phone:410-324-3960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health