NPIMap

Organization Active NPI

Soul-Full Solutions Counseling Center, LLC

  • Professional Counselor
  • Merrill, WI
National Provider Identifier
1508010653
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2450 Issued in WI
Legal business name
SOUL-FULL SOLUTIONS COUNSELING CENTER, LLC
Practice address
423 Grand Ave
Merrill, WI 54452-2220
Phone
(715) 805-6111
Fax
(715) 539-8000
NPI assigned
Nov 14, 2008
Last updated
Nov 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Miss Linda J Haynes, MS, LPCNPI 1982625570
Title
Owner
Phone
(715) 805-6111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X 2450 WI Primary

Addresses

Primary practice location

423 Grand Ave
Merrill, WI 54452-2220

Mailing address

PO Box 395
423 Grand Ave
Merrill, WI 54452-0395
Phone (715) 805-6111

Other identifiers 1

IdentifierTypeStateIssuer
42253700MedicaidWI

National Provider Directory

National Provider Directory

Locations

423 Grand Ave
Merrill, WI 54452
Phone (715) 805-6111

Practitioners & affiliated clinicians

Practitioners 1

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": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1508010653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "address_2": "423 GRAND AVE",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544520395",
            "telephone_number": "715-805-6111",
            "fax_number": "715-539-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 GRAND AVE",
            "city": "MERRILL",
            "state": "WI",
            "postal_code": "544522220",
            "telephone_number": "715-805-6111",
            "fax_number": "715-539-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL-FULL SOLUTIONS COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-805-6111",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "2450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42253700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrill, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.