NPIMap

Organization Active NPI

Soul-Renity, LLC

  • Professional Counselor
  • Baltimore, MD
National Provider Identifier
1962849133
Registry record updated May 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC2447 Issued in MD
Legal business name
SOUL-RENITY, LLC
Practice address
1601 Saint Paul St
2ND Floor
Baltimore, MD 21202-4871
Phone
(410) 921-9800
Fax
(410) 928-4222
NPI assigned
May 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2017

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

Authorized official

Name
Ms. Kier Michelle Johnson, LCPCNPI 1063525673
Title
Psychotherapist
Phone
(410) 921-9800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LC2447 MD Primary

Addresses

Primary practice location

1601 Saint Paul St
2ND Floor
Baltimore, MD 21202-4871

Mailing address

1601 Saint Paul St
2ND Floor
Baltimore, MD 21202-4871
Phone (410) 921-9800

Other identifiers 1

IdentifierTypeStateIssuer
304800400MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Soul-Renity LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494201600000",
    "number": "1962849133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 SAINT PAUL ST",
            "address_2": "2ND FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024871",
            "telephone_number": "410-921-9800",
            "fax_number": "410-928-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 SAINT PAUL ST",
            "address_2": "2ND FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212024871",
            "telephone_number": "410-921-9800",
            "fax_number": "410-928-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUL-RENITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2017-05-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "410-921-9800",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC2447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304800400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; 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.