Provider Demographics
NPI:1144813379
Name:PEACEFUL SOUL HEALING, PLLC
Entity type:Organization
Organization Name:PEACEFUL SOUL HEALING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:KULSHRESHTHA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-487-3880
Mailing Address - Street 1:4046 NE 55TH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-2266
Mailing Address - Country:US
Mailing Address - Phone:206-612-3353
Mailing Address - Fax:
Practice Address - Street 1:1728 E MADISON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2733
Practice Address - Country:US
Practice Address - Phone:206-487-3880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)