Soulspace Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOULSPACE COUNSELING LLC

Practice address

28 Roseleah Dr
Waterford, CT 06385-4310

Phone

(860) 941-4743

Fax

(860) 941-4743

NPI assigned

Jul 31, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Mariah Fairley, LPCNPI 1982278594

Title

Owner

Phone

(860) 941-4743

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mariah Angeline Fairley, MA

  • Mental Health Counselor
  • New London, CT
  • NPI 1982278594
  NPD Authorized official

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722729600000",
    "number": "1811726482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ROSELEAH DR",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854310",
            "telephone_number": "860-941-4743",
            "fax_number": "860-941-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 ROSELEAH DR",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854310",
            "telephone_number": "860-941-4743",
            "fax_number": "860-941-4743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "554 Long Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Groton",
            "state": "CT",
            "postal_code": "063404170",
            "country_code": "US",
            "telephone_number": "860-941-4743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOULSPACE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-08-04",
        "certification_date": "2024-08-04",
        "status": "A",
        "authorized_official_last_name": "FAIRLEY",
        "authorized_official_first_name": "MARIAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-941-4743",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Rose Smith, MS, RDN, CSO
• Katherine Carol Snyder, LMFT
• Kamila Somayaji, MD
• Mark Somers, M.D.
• Adrianne Sostre, L.P.C.
• Southeastern Connecticut Imaging Center, LLC
• Southern New England Anesthesia Partners, PLLC
• Melina Spanos, NP
• Sparrows Worth Wellness Services
• Spectrum Physical Therapy Limited Partnership

• Professional Counselor in Waterford, CT
• Providers in Waterford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.