Charles R Soule, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

012945 Issued in NY

Practice address

20 W 86TH St
Ste. 1a
New York, NY 10024-3604

Phone

(212) 560-2406

NPI assigned

Feb 5, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1639218035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 W 95TH ST",
            "address_2": "APT. 5E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100258600",
            "telephone_number": "646-271-9089",
            "fax_number": "212-305-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W 86TH ST",
            "address_2": "STE. 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100243604",
            "telephone_number": "212-560-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOULE",
        "first_name": "CHARLES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012945",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "012945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSED PSYCHOLOGIST",
            "identifier": "012945",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marisol Soula, MD/PHD
• Virginia Gerhart Soules, M.D.
• Soulful Grace LCSW PLLC
• Soulutions Psychotherapy
• Aminata Soumare, MD
• Amir Soumekh, M.D.

• Clinical Child & Adolescent Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Child & Adolescent Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.