Organization Active NPI

Soulshine Counseling Services, LLC

  • Professional Counselor
  • Sylvania, GA
National Provider Identifier
1447823976
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
SOULSHINE COUNSELING SERVICES, LLC
Practice address
215 Industrial Rd
Sylvania, GA 30467-1866
Phone
(912) 209-5941
Fax
(912) 567-3600
NPI assigned
Jul 22, 2021
Last updated
Mar 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
K. Michelle Ware, LPC
Title
Owner
Phone
(912) 209-5941

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

215 Industrial Rd
Sylvania, GA 30467-1866

Mailing address

PO Box 1982
Sylvania, GA 30467-7182

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240205000206 GA Part B Supplier - Clinic/Group Practice 7315380672 Receives reassigned benefits from 1 practitioner
Practice locations: Sylvania, GA

National Provider Directory

National Provider Directory

Locations

106 E Ogeechee St
Sylvania, GA 30467

215 Industrial Rd
Sylvania, GA 30467
Phone (912) 209-5941

316 W Ogeechee St
Ste D
Sylvania, GA 30467
Phone (912) 687-2611

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1447823976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1982",
            "city": "SYLVANIA",
            "state": "GA",
            "postal_code": "304677182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 INDUSTRIAL RD",
            "city": "SYLVANIA",
            "state": "GA",
            "postal_code": "304671866",
            "telephone_number": "912-209-5941",
            "fax_number": "912-567-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSHINE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-22",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "K. MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-209-5941",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sylvania, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.