Soulcare Health, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

SOULCARE HEALTH, LLC

Doing business as

Soulcare Health, LLC

Practice address

250 Constitution Blvd
Lawrenceville, GA 30046-8432

Phone

(470) 844-0157

Fax

(678) 539-8899

NPI assigned

Feb 13, 2023

Last updated

May 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glory O Osadiaye, APRNNPI 1003490764

Title

Pmhnp

Phone

(678) 978-4151

Specialties & licenses 3

Addresses

Other names 1

• Soulcare Health, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Glory Osadiaye, PMHNP, MSN, BSN, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
  • NPI 1003490764
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685059200000",
    "number": "1851098651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 MARTIN FIELD DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300455270",
            "telephone_number": "678-978-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CONSTITUTION BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468432",
            "telephone_number": "470-844-0157",
            "fax_number": "678-539-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULCARE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A",
        "authorized_official_last_name": "OSADIAYE",
        "authorized_official_first_name": "GLORY",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PMHNP",
        "authorized_official_telephone_number": "678-978-4151",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soulcare Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Soulcare Health, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Perla Johana Sorto, BA/PP
• Sherley Marissa Sosa, BCBA
• Katelyn Soska
• Luz Melania Soto Garcia, MA
• Maria B. Soto, M.D.
• South East Kidney Home Dialysis (SK Home Dialysis)
• Southern Charm Anesthesia Associates
• Southern Clinical Laboratory Inc.
• Southern Dermatology PC
• Southern Endoscopy Suite, LLC

• Adult Mental Health Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Adult Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.