Soul Savvy Counseling and Therapy Services LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

SOUL SAVVY COUNSELING AND THERAPY SERVICES LLC

Practice address

11901 Central Park Way Unit 2327
Maple Grove, MN 55369-2664

Phone

(612) 701-3084

Fax

(612) 500-4671

NPI assigned

Apr 7, 2021

Organization subpart

No

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

Authorized official

Name

Robert David Andrews-Mendoza, LADCNPI 1558824490

Title

Owner

Phone

(612) 712-7785

Specialties & licenses 1

Addresses

Practitioners 1

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

• Robert David Andrews-Mendoza, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Maple Grove, MN
  • NPI 1558824490
  NPD Authorized official

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1346829025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 CENTRAL PARK WAY UNIT 2327",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692664",
            "telephone_number": "612-701-3084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 CENTRAL PARK WAY UNIT 2327",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692664",
            "telephone_number": "612-701-3084",
            "fax_number": "612-500-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL SAVVY COUNSELING AND THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "ANDREWS-MENDOZA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-712-7785",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.