NPIMap

Organization Active NPI

Elton'S Soul to Soul Company

  • Mental Health Counselor
  • Roanoke, VA
National Provider Identifier
1104465129
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
ELTON'S SOUL TO SOUL COMPANY
Practice address
3247 Electric Rd Ste 1a
Roanoke, VA 24018-6448
Phone
(540) 772-0690
Fax
(540) 772-0692
NPI assigned
Dec 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Nicole Carpenter Elton, LCSWNPI 1467756130
Title
Provider
Phone
(540) 353-2244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3247 Electric Rd Ste 1a
Roanoke, VA 24018-6448

Mailing address

6776 Hidden Woods Dr
Roanoke, VA 24018-7480
Phone (540) 353-2244

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1104465129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6776 HIDDEN WOODS DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240187480",
            "telephone_number": "540-353-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3247 ELECTRIC RD STE 1A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240186448",
            "telephone_number": "540-772-0690",
            "fax_number": "540-772-0692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELTON'S SOUL TO SOUL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-23",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "ELTON",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "CARPENTER",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "540-353-2244",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.