Soda Ventures LLC. D.B.a. 92 Reasons

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SODA VENTURES LLC. D.B.A. 92 REASONS

Practice address

1332 Teasley LN Ste 103a
Denton, TX 76205-7946

Phone

(469) 986-9629

Fax

(469) 453-3193

NPI assigned

Feb 21, 2020

Last updated

Feb 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sophia Cannon, CRC, LPCNPI 1205355260

Title

Director of Clinical Services

Phone

(469) 986-9629

Specialties & licenses 4

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sophia Ayana Cannon, MCRC, CRC, LPC

  • Professional Counselor
  • Denton, TX
  • NPI 1205355260
  NPD Authorized official

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1285267914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 TEASLEY LN STE 103A",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057946",
            "telephone_number": "469-986-9629",
            "fax_number": "469-453-3193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 TEASLEY LN STE 103A",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057946",
            "telephone_number": "469-986-9629",
            "fax_number": "469-453-3193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SODA VENTURES LLC. D.B.A. 92 REASONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "469-986-9629",
        "authorized_official_credential": "CRC, LPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Denton, TX
• Providers in Denton, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.