NPIMap

Organization Active NPI

Soul Ambition, Inc.

  • Counseling Psychologist
  • Boynton Beach, FL
National Provider Identifier
1669028957
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
SOUL AMBITION, INC.
Practice address
1375 Gateway Blvd Ste 32
Boynton Beach, FL 33426-8304
Phone
(561) 314-5074
NPI assigned
Aug 13, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Authorized official

Name
Ms. Julie Ahbol
Title
Owner
Phone
(561) 314-5074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

1375 Gateway Blvd Ste 32
Boynton Beach, FL 33426-8304

Mailing address

1375 Gateway Blvd Ste 32
Boynton Beach, FL 33426-8304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260402003873 FL Part B Supplier - Clinic/Group Practice 6204311699 Receives reassigned benefits from 17 practitioners
Practice locations: Boynton Beach, FL

National Provider Directory

National Provider Directory

Locations

1375 Gateway Blvd
Ste 32
Boynton Beach, FL 33426
Phone (561) 307-3703

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565654400000",
    "number": "1669028957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 GATEWAY BLVD STE 32",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 GATEWAY BLVD STE 32",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268304",
            "telephone_number": "561-314-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL AMBITION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-13",
        "last_updated": "2019-08-13",
        "status": "A",
        "authorized_official_last_name": "AHBOL",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-314-5074",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; 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.