Soul Spark Counseling & Consult, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOUL SPARK COUNSELING & CONSULT, LLC

Practice address

2112 Bienville Blvd Ste M1
Ocean Springs, MS 39564-3027

Phone

(601) 385-5638

Fax

(228) 366-9056

NPI assigned

Jan 17, 2023

Organization subpart

No

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

Authorized official

Name

Mary Dodson, LMFT

Title

Manager

Phone

(985) 774-4076

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721260800000",
    "number": "1205541000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14205 S COUNTRY HILLS DR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032518",
            "telephone_number": "985-774-4076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 BIENVILLE BLVD STE M1",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643027",
            "telephone_number": "601-385-5638",
            "fax_number": "228-366-9056"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14205 S Country Hills Dr",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395032518",
            "country_code": "US",
            "telephone_number": "985-774-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUL SPARK COUNSELING & CONSULT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-17",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "985-774-4076",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Ocean Springs, MS
• Providers in Ocean Springs, MS by specialty
• Mental Health Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.