Soulshine Integrative Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOULSHINE INTEGRATIVE WELLNESS, LLC

Practice address

1788 Gibou Rd
Montgomery Center, VT 05471-2032

Phone

(802) 327-3720

NPI assigned

Jul 10, 2024

Organization subpart

No

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

Authorized official

Name

Amie Koontz, LCMCH, LMT

Title

Clinical Mental Health Counselor

Phone

(802) 327-3720

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1760229512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1788 GIBOU RD",
            "city": "MONTGOMERY CENTER",
            "state": "VT",
            "postal_code": "054712032",
            "telephone_number": "802-327-3720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1788 GIBOU RD",
            "city": "MONTGOMERY CENTER",
            "state": "VT",
            "postal_code": "054712032",
            "telephone_number": "802-327-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSHINE INTEGRATIVE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A",
        "authorized_official_last_name": "KOONTZ",
        "authorized_official_first_name": "AMIE",
        "authorized_official_title_or_position": "CLINICAL MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "802-327-3720",
        "authorized_official_credential": "LCMCH, LMT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Kaufman, M.D.
• Amie Koontz, CMHC
• Town of Montgomery (Montgomery Rescue)

• Mental Health Counselor in Montgomery Center, VT
• Providers in Montgomery Center, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.