NPIMap

Organization Active NPI

Soul Connections, PLLC

  • Clinical Social Worker
  • Yakima, WA
National Provider Identifier
1366257552
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SOUL CONNECTIONS, PLLC
Practice address
1015 S 40TH Ave
Yakima, WA 98908-3806
Phone
(253) 961-3629
NPI assigned
Feb 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Crystal M Tyree, LICSWNPI 1609231323
Title
Owner
Phone
(253) 961-3629

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1015 S 40TH Ave
Yakima, WA 98908-3806

Mailing address

591 Watson Rd
Yakima, WA 98908-9469
Phone (253) 961-3629

Other names 1

  • Soul Connections Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250502001811 WA Part B Supplier - Clinic/Group Practice 8123545118 Receives reassigned benefits from 1 practitioner
Practice locations: Yakima, WA

National Provider Directory

National Provider Directory

Locations

1015 S 40th Ave
Ste 2123
Yakima, WA 98908
Phone (253) 961-3629

1015 S 40th Ave
Yakima, WA 98908
Phone (509) 367-6130

Practitioners & affiliated clinicians

Practitioners 9

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": "1739318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1366257552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "591 WATSON RD",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989089469",
            "telephone_number": "253-961-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 S 40TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083806",
            "telephone_number": "253-961-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL CONNECTIONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "TYREE",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-961-3629",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soul Connections Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.