Soul Journey Therapy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.009440 Issued in VT

Legal business name

SOUL JOURNEY THERAPY

Practice address

167 Main St
Suite 207E
Brattleboro, VT 05301-7128

Phone

(802) 451-6598

NPI assigned

Nov 4, 2014

Last updated

Aug 31, 2016By 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

Supriya Shanti, LICSW

Title

Founder, Therapist

Phone

(802) 451-6598

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1346645223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "address_2": "BOX 17",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017128",
            "telephone_number": "802-451-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "address_2": "SUITE 207E",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017128",
            "telephone_number": "802-451-6598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL JOURNEY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "SHANTI",
        "authorized_official_first_name": "SUPRIYA",
        "authorized_official_title_or_position": "FOUNDER, THERAPIST",
        "authorized_official_telephone_number": "802-451-6598",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.009440",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VT",
            "license": "089.009440",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy A Smith, RNBSN
• Christopher Snow, PA
• Jilisa Snyder
• Randall G Snyder
• Anna Soles, BCBA ABA MS
• Southern Vermont Health Services Corp
• Southern Vermont Orthopaedic &
• Anna Spence, DDS
• Stephen Alan Spitzer, LICSW
• Carol Stack, APRN

• Clinical Social Worker in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.