Soul Sanctuary LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOUL SANCTUARY LLC

Practice address

534 S Pineapple Ave Ste 5
Sarasota, FL 34236-7024

Phone

(941) 312-1881

NPI assigned

Oct 14, 2019

Organization subpart

No

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

Authorized official

Name

Salina R Martin

Title

Owner

Phone

(941) 312-1881

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571011200000",
    "number": "1962044685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 S PINEAPPLE AVE STE 5",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342367024",
            "telephone_number": "941-312-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 S PINEAPPLE AVE STE 5",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342367024",
            "telephone_number": "941-312-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL SANCTUARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2019-10-14",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SALINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-312-1881"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Theranest",
            "affiliation": "N",
            "endpointDescription": "ERM portal",
            "address_1": "534 S Pineapple Ave Ste 5",
            "city": "Sarasota",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342367024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Mental Health Counselor in Sarasota, FL
• Providers in Sarasota, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2019; 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.