Organization Active NPI

Soulbird Integrative

  • Mental Health Counselor
  • McHenry, IL
National Provider Identifier
1306642590
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
SOULBIRD INTEGRATIVE
Practice address
1941 Hemlock Dr
McHenry, IL 60050-2652
Phone
(773) 353-6259
Fax
(903) 265-4867
NPI assigned
Feb 20, 2025
Last updated
Feb 20, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Jasmine Tudy, LMFT
Title
Owner
Phone
(773) 353-6259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1941 Hemlock Dr
McHenry, IL 60050-2652

Mailing address

1941 Hemlock Dr
McHenry, IL 60050-2652
Phone (773) 353-6259

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1740009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1306642590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 HEMLOCK DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600502652",
            "telephone_number": "773-353-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 HEMLOCK DR",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600502652",
            "telephone_number": "773-353-6259",
            "fax_number": "903-265-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULBIRD INTEGRATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-20",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "TUDY",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-353-6259",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.