Resilient Soul

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

RESILIENT SOUL

Practice address

1001 S Bradford St Ste 3
Dover, DE 19904-4153

Phone

(302) 828-1273

NPI assigned

Jan 13, 2021

Organization subpart

No

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

Authorized official

Name

Kimberly Brown

Title

Billing Manager

Phone

(302) 241-8636

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1225627318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S BRADFORD ST STE 3",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044153",
            "telephone_number": "302-828-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S BRADFORD ST STE 3",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199044153",
            "telephone_number": "302-828-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT SOUL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-13",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "302-241-8636"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000593172",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Dover, DE
• Providers in Dover, DE by specialty
• Mental Health Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.