SOULCIAL SANCTUARY,LLC (NPI# 1053878108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053878108 |
| Entity Type | Organization |
| Organization Name | SOULCIAL SANCTUARY,LLC |
| Other Organization Name | SOULCIAL SANCTUARY,LLC |
| Practice Address |
2051 Beacon Landing Cir Orlando FL 32824-4373 |
| Practice Telephone | 4077919693 |
| Mailing Telephone | 4077919693 |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-03-04 |
| Authorized Official Name | CHARLETTE THOMAS (THERAPY/MEDIATION) |
| Authorized Official Telephone | 4077919693 |
| Authorized Official Credential | MASTERS DEGREE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Soulcial Sanctuary,LLC | Former Legal Business Name - Organization |
| Street Address |
2051 BEACON LANDING CIR |
| City | ORLANDO |
| State | FL |
| Zip Code | 32824-4373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013572262 | Laura Enid Martinez | Driver | 2131 Ribbon Falls Pkwy, Orlando, FL 32824 | 2019-05-03 |
| 1629555800 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 14185 Lake Nona Blvd., Orlando, FL 32824 | 2018-07-20 |
| 1740705789 | Ambar Transportation LLC | Non-emergency Medical Transport (VAN) | 2214 Brandywine Falls Way, Orlando, FL 32824 | 2017-08-10 |
| 1528582798 | Carlos E Melgarejo | Case Manager/Care Coordinator | 3467 Somerset Park Dr, Orlando, FL 32824 | 2017-07-31 |
| 1346786621 | Kimkesi Morgan | Clinic/Center | 14365 Queenside St, Orlando, FL 32824 | 2017-01-11 |
| 1154772978 | Azalia Carballo | Behavior Technician | 14940 Day Lily Ct, Orlando, FL 32824 | 2016-06-22 |
| 1326413931 | Marlene Alix | Nurse Practitioner | 12108 Greco Dr., Orlando, FL 32824 | 2015-12-08 |
| 1508230202 | Sandra Pinzon | Case Management | 579 Bohannon Blvd, Orlando, FL 32824 | 2015-11-18 |
| 1225402993 | Cristina Villafane | Speech-Language Pathologist | 3755 Bishop Landing Way, Orlando, FL 32824 | 2015-11-18 |
| 1891171625 | Nidia Xaymara Feliberti | Counselor | 14975 Huntcliff Park Way, Orlando, FL 32824 | 2015-08-04 |
| Find all providers in zip 32824 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528460 | Matthew Edward Winkles | Marriage & Family Therapist | 1215 E Robinson St, Orlando, FL 32801-2115 | 2020-11-03 |
| 1245855576 | Elizabeth Havens | Marriage & Family Therapist | 1230 Hillcrest St Ste 101, Orlando, FL 32803-4713 | 2020-06-12 |
| 1801410378 | Jamie Sue Gunning | Marriage & Family Therapist | 801 N Magnolia Ave Ste 318, Orlando, FL 32803-3843 | 2020-06-01 |
| 1093342008 | Christopher Venezia | Marriage & Family Therapist | 3125 Bruton Blvd Ste A, Orlando, FL 32805-6608 | 2020-03-27 |
| 1932735032 | Nina Elder | Marriage & Family Therapist | 1107 Lake Baldwin Ln Unit 107, Orlando, FL 32814-6814 | 2020-03-20 |
| 1407415342 | Betty Carrol | Marriage & Family Therapist | 1516 E Colonial Dr Ste 100, Orlando, FL 32803 | 2019-06-12 |
| 1063908150 | Chad Christopher Chieffallo | Marriage & Family Therapist | 3611 Conroy Rd Apt 828, Orlando, FL 32839-2470 | 2018-07-02 |
| 1760983456 | Kathleen R Meeks | Marriage & Family Therapist | 4019 Clarcona Ocoee Rd, Orlando, FL 32810-4270 | 2018-02-27 |
| 1932625183 | Alina Schindler | Marriage & Family Therapist | 100 W Grant St Apt 3017, Orlando, FL 32806-3966 | 2017-08-19 |
| 1386091304 | Johnnie Kramer Jr. | Marriage & Family Therapist | 3127 San Leo Dr, Orlando, FL 32820-1429 | 2016-05-19 |
| Find all providers in ORLANDO | ||||
Please comment or provide details below to improve the information on SOULCIAL SANCTUARY,LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.