SOULSPACE WELLNESS CENTER (NPI# 1093348781) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093348781 |
Entity Type | Organization |
Organization Name | SOULSPACE WELLNESS CENTER |
Practice Address |
1026 W 11 Mile Rd Royal Oak MI 48067-5401 |
Mailing Address |
1923 Ardmore Ave Royal Oak MI 48073-4179 |
Practice Telephone | 2483975080 |
Mailing Telephone | 2488244085 |
Enumeration Date | 2020-02-20 |
Last Update Date | 2020-02-20 |
Authorized Official Name | ERICA CARULLI (OWNER / PSYCHOTHERAPIST) |
Authorized Official Telephone | 2483975080 |
Authorized Official Credential | MA, LPC |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
Street Address |
1026 W 11 MILE RD |
City | ROYAL OAK |
State | MI |
Zip Code | 48067-5401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447434063 | Nancy C Adair | Social Worker | 1026 W 11 Mile Rd, Ste C, Royal Oak, MI 48067-5403 | 2007-12-18 |
1518435635 | Tracy Lynn Niyo | Social Worker | 1026 W 11 Mile Rd, Royal Oak, MI 48067-5401 | 2018-11-06 |
1649562869 | Bart Allen Burger | Psychologist | 1026 W 11 Mile Rd, Suite C, Royal Oak, MI 48067-5401 | 2011-05-05 |
1417280546 | Christine C. Cantrell, Phd, LLC | Community/Behavioral Health | 1026 W 11 Mile Rd, Suite C, Royal Oak, MI 48067-5401 | 2009-09-08 |
1821261736 | Denise Joseph | Psychologist | 1026 W 11 Mile Rd, Suite C, Royal Oak, MI 48067-5401 | 2008-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922609072 | George Edward Khamis | Psychologist | 25600 Woodward Avenue, Suite 215, Royal Oak, MI 48067 | 2020-11-05 |
1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
1750917811 | Sonia B Shah-gonzalez | Case Management | 830 E Fourth St, #1, Royal Oak, MI 48067 | 2020-03-19 |
1568022960 | Woodo Pharmacy LLC | Pharmacy | 909 E 11 Mile Rd, Royal Oak, MI 48067 | 2019-06-18 |
1093217564 | Sharon Diane Malinowski | Occupational Therapist | 4949 Coolidge Hwy Section E, Adult Neuro Ot, Royal Oak, MI 48067 | 2018-03-01 |
1962916569 | Nuch of Michigan Inc | Clinic/Center | 2140 E 12 Mile Rd, Royal Oak, MI 48067 | 2017-11-20 |
1629420179 | Christine Paige | Homeopath | 1112 Catalpa, Royal Oak, MI 48067 | 2016-07-08 |
1104277045 | Rppc Labs, LLC | Clinical Medical Laboratory | 26154 Woodward Ave Ste 5, Royal Oak, MI 48067 | 2016-06-22 |
1346606423 | Thomas Michalos | Counselor | 402 S. Lafayette, Royal Oak, MI 48067 | 2016-01-05 |
1508234212 | Valetta Aldridge | Registered Nurse | 28000 Woodward, Royal Oak, MI 48067 | 2015-09-11 |
Find all providers in zip 48067 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982147302 | Wise Mind Pllc | Clinic/Center | 905 S Center St, Royal Oak, MI 48067-3230 | 2016-12-02 |
1326317462 | Jump Start Consulting, LLC | Clinic/Center | 317 E 11 Mile Rd, Royal Oak, MI 48067-2735 | 2011-12-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225637267 | Thompson Counseling & Consulting LLC | Clinic/Center | 36500 Ford Rd Ste 329, Westland, MI 48185-3769 | 2020-10-21 |
1720685464 | Thiera Danyal Therapy and Wellness LLC | Clinic/Center | 10216 Beaconsfield St, Detroit, MI 48224-2573 | 2020-10-06 |
1871100602 | Sbh Ventures LLC | Clinic/Center | 700 Golfcrest Dr, Dearborn, MI 48124-1121 | 2020-09-25 |
1558978593 | Katie M Wyss Lmsw, LLC | Clinic/Center | 218 N 4th Ave Ste 207, Ann Arbor, MI 48104-1472 | 2020-09-24 |
1700492154 | Bound Together Counseling, Pllc | Clinic/Center | 3020 Franklin Park Dr, Sterling Heights, MI 48310-2477 | 2020-09-21 |
1982219556 | Best Life Counseling Services, LLC | Clinic/Center | O-745 Lake Michigan Dr Nw, Grand Rapids, MI 49534-6795 | 2020-09-10 |
1780297879 | Grisham Services Inc. | Clinic/Center | 710 Chippewa Sq Ste 206, Marquette, MI 49855-4823 | 2020-08-28 |
1518579655 | Self Preservation Through Recovery Independence Transformation Guidanc | Clinic/Center | 21225 Kelly Rd Ste 5, Eastpointe, MI 48021-3100 | 2020-08-19 |
1639789688 | Itherapygenx, Pllc | Clinic/Center | 31701 Grandview Ave, Westland, MI 48186-8958 | 2020-08-05 |
1619595832 | Peace of Mind, LLC | Clinic/Center | 41750 Foster Dr Unit 204, Novi, MI 48375-1976 | 2020-07-14 |
Find all providers with the same taxonomy |
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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.