Heart and Soul Wellness Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

HEART AND SOUL WELLNESS CLINIC LLC

Practice address

1025 2ND St NW
Salem, OR 97304-4001

Phone

(503) 689-1381

NPI assigned

Nov 27, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jill Cohen, DNP FNP

Title

FNP

Phone

(503) 428-2498

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1326684135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 2ND ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044001",
            "telephone_number": "503-689-1381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 2ND ST NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973044001",
            "telephone_number": "503-689-1381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART AND SOUL WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "FNP",
        "authorized_official_telephone_number": "503-428-2498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthy Smiles Family Dental LLC
• Mark D Healy, OTRL CHT
• Gary Henry Heard, BA, CADC II
• Jennifer A Hearn, PSS
• Lorraine Hearn, MA, QMHP
• Brandelynn Heath
• Dava Jean Heath
• Susan Ann Heath, LCSW
• Amanda Heather, LCSW
• James Earl Heder, MD

• Clinic/Center in Salem, OR
• Providers in Salem, OR by specialty
• Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2019; 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.