Provider Demographics
NPI:1982112025
Name:SOUL AFFIRMING COUNSELING, LLC
Entity Type:Organization
Organization Name:SOUL AFFIRMING COUNSELING, LLC
Other - Org Name:SOUL AFFIRMING COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHARANYI
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:334-539-8051
Mailing Address - Street 1:PO BOX 834
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36831-0834
Mailing Address - Country:US
Mailing Address - Phone:334-539-8051
Mailing Address - Fax:205-625-4820
Practice Address - Street 1:318 N COLLEGE ST STE G
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-3815
Practice Address - Country:US
Practice Address - Phone:334-539-8051
Practice Address - Fax:205-625-4820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3830C104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467990002OtherINDIVIDUAL NPI