Organization Active NPI

Soul Bridge Ministry

  • Professional Counselor
  • Frisco, TX
National Provider Identifier
1336955780
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SOUL BRIDGE MINISTRY
Practice address
6136 Frisco Square Blvd Ste 400
Frisco, TX 75034-3251
Phone
(337) 255-2836
Fax
(469) 727-5593
NPI assigned
Dec 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Authorized official

Name
Joel Qiao, LPC
Title
Board Director
Phone
(337) 255-2836

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

6136 Frisco Square Blvd Ste 400
Frisco, TX 75034-3251

Mailing address

4801 Witten Park Way
McKinney, TX 75070-8670
Phone (337) 255-2836

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.

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1336955780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 WITTEN PARK WAY",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750708670",
            "telephone_number": "337-255-2836",
            "fax_number": "469-727-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 FRISCO SQUARE BLVD STE 400",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750343251",
            "telephone_number": "337-255-2836",
            "fax_number": "469-727-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL BRIDGE MINISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "QIAO",
        "authorized_official_first_name": "JOEL",
        "authorized_official_title_or_position": "BOARD DIRECTOR",
        "authorized_official_telephone_number": "337-255-2836",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.