NPIMap

Organization Active NPI

Metamorphosis Soul Healing, LLC

  • Marriage & Family Therapist
  • Smyrna, DE
National Provider Identifier
1578157293
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
METAMORPHOSIS SOUL HEALING, LLC
Practice address
74 Liborio LN
Smyrna, DE 19977-7711
Phone
(484) 816-8510
NPI assigned
Feb 23, 2021
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Jeanne Felicia Mayo, LMFT
Title
Owner
Phone
(484) 816-8510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary

Addresses

Primary practice location

74 Liborio LN
Smyrna, DE 19977-7711

Mailing address

74 Liborio LN
Smyrna, DE 19977-7711
Phone (484) 816-8510

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Smyrna
Other URL Smyrna

National Provider Directory

National Provider Directory

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": "1614038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1578157293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 LIBORIO LN",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199777711",
            "telephone_number": "484-816-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 LIBORIO LN",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199777711",
            "telephone_number": "484-816-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAMORPHOSIS SOUL HEALING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "MAYO",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "FELICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-816-8510",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Smyrna",
            "affiliation": "N",
            "address_1": "74 Liborio Ln",
            "city": "Smyrna",
            "state": "DE",
            "country_code": "US",
            "postal_code": "199777711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Smyrna",
            "affiliation": "N",
            "address_1": "74 Liborio Ln",
            "city": "Smyrna",
            "state": "DE",
            "country_code": "US",
            "postal_code": "199777711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Smyrna, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.