SOUL-RENITY, LLC


Address: 1601 Saint Paul St, 2nd Floor, Baltimore, MD 21202-4871
Phone: 4109219800

SOUL-RENITY, LLC (NPI# 1962849133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1962849133
Entity Type Organization
Organization Name SOUL-RENITY, LLC
Practice Address 1601 Saint Paul St
2nd Floor
Baltimore
MD 21202-4871
Practice Telephone 4109219800
Practice Fax Number 4109284222
Mailing Telephone 4109219800
Mailing Fax Number 4109284222
Enumeration Date 2013-05-29
Last Update Date 2017-05-08
Authorized Official Name MS. KIER MICHELLE JOHNSON (PSYCHOTHERAPIST)
Authorized Official Telephone 4109219800
Authorized Official Credential LCPC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
LC2447 MD Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MD 304800400 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1972900595 Soul-renity, LLC Counselor 3602 Mohawk Ave, Suite 200, Baltimore, MD 21207-7665 2014-11-25

Office Location

Street Address 1601 SAINT PAUL ST
2ND FLOOR
City BALTIMORE
State MD
Zip Code 21202-4871

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1700430246 Ronie George Nurse Practitioner 345 St. Paul Place Dept of Pediatrics, Baltimore, MD 21202 2019-08-01
1750940185 Katherine Wachter Mullins Social Worker 200 East North Ave, Related Services - Rm 210, Baltimore, MD 21202 2019-06-10
1720647175 Ivelysse Claudio Cortes Speech-Language Pathologist Rsu/ofic of Spec Educ- Speech-language Department, 200 E North Avenue, Room 211, Baltimore, MD 21202 2019-06-10
1497314157 Debera Marie Reznitsky Speech-Language Pathologist 200 East North Avenue, Related Services Rm 210, Baltimore, MD 21202 2019-06-06
1154989952 Zirka Oksanna Hanas Speech-Language Pathologist 200 E. North Avenue, Related Services Room #210, Baltimore, MD 21202 2019-06-05
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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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1912529595 Anna Coleen Mahr Counselor 9700 Old Harford Rd, Baltimore, MD 21234-1140 2020-05-18
1902428352 Bridgette Eaton Counselor 3501 Saint Paul St Apt 147, Baltimore, MD 21218-2726 2020-05-08
1447870514 Diane Moses Counselor 1721 Pennsylvania Ave # 205, Baltimore, MD 21217-3119 2020-04-19
1649804840 Brittany Michelle Chadsey Counselor 1 N Charles St Ste 602, Baltimore, MD 21201-3732 2020-02-26
1467084871 Amanda Steinhorn, LLC Counselor 7225 Brookfalls Ter, Baltimore, MD 21209-1646 2020-02-04
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Competitor

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City BALTIMORE
Zip Code 21202

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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