Soul Renewal Family Counseling Inc

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOUL RENEWAL FAMILY COUNSELING INC

Doing business as

Soul Renewal Family Counseling, Inc.

Practice address

7737 Pacific Ave
Lemon Grove, CA 91945-1740

Phone

(619) 438-0880

NPI assigned

Jul 15, 2019

Organization subpart

No

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

Authorized official

Name

Patricia Johnson Mims, LMFTNPI 1508418971

Title

Director

Phone

(619) 439-2499

Specialties & licenses 1

Addresses

Other names 1

• Soul Renewal Family Counseling, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Patricia Johnson Mims, LMFT

  • Marriage & Family Therapist
  • Lemon Grove, CA
  • NPI 1508418971
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1295387603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 PACIFIC AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451740",
            "telephone_number": "619-439-2499",
            "fax_number": "619-439-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 PACIFIC AVE",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451740",
            "telephone_number": "619-438-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL RENEWAL FAMILY COUNSELING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-15",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "JOHNSON",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "619-439-2499",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soul Renewal Family Counseling, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Rosha Smith
• Mathew H Snell, SUDRC
• Theresa Ann Solis, LVN
• Gerardo Soliven
• Heather Sorrentino, RADT
• Candice Stamper
• Stars and Stripes Homes
• Violeta Steier, CNA
• Andrea Michelle Stewart, MFT
• Shawn Paul Stoddard, D.C.

• Mental Health Counselor in Lemon Grove, CA
• Providers in Lemon Grove, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.