Kaleidosoul LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

KALEIDOSOUL LLC

Practice address

220 Lanier Ave E Ste 7
Fayetteville, GA 30214-1604

Phone

(678) 545-6692

Fax

(678) 519-5673

NPI assigned

May 26, 2022

Organization subpart

No

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

Authorized official

Name

Stacey Nicole Paxton, LPC, CAMS,CMACNPI 1194276071

Title

Owner

Phone

(785) 456-6926

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Stacey Nicole Paxton, LPC

  • Professional Counselor
  • Fayetteville, GA
  • NPI 1194276071
  NPD Authorized official

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1407594658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 LANIER AVE E STE 7",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141604",
            "telephone_number": "678-545-6692",
            "fax_number": "678-519-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 LANIER AVE E STE 7",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141604",
            "telephone_number": "678-545-6692",
            "fax_number": "678-519-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALEIDOSOUL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "PAXTON",
        "authorized_official_first_name": "STACEY NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-456-6926",
        "authorized_official_credential": "LPC, CAMS,CMAC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kadesh Economic Partners Inc
• Nikhil Kadle, MD
• Kaiser Foundation Health Plan of Georgia, Inc.
• Kaiser Permanente
• Ajay Kumar Kaja, MBBS
• Kelly Anne Kallis, CFNP
• Vinisha Kalra
• Kiran J Kanji, M.D.
• Mukti Bhatia Kanji, D.O.
• Rashaundria Kanu, CCC-SLP

• Professional Counselor in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.