Provider Demographics
NPI:1922826825
Name:SOULFUL BALANCE COUNSELING INC
Entity type:Organization
Organization Name:SOULFUL BALANCE COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:716-574-6910
Mailing Address - Street 1:152 LIVERPOOL ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-5264
Mailing Address - Country:US
Mailing Address - Phone:716-574-6910
Mailing Address - Fax:
Practice Address - Street 1:152 LIVERPOOL ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-5264
Practice Address - Country:US
Practice Address - Phone:716-574-6910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty