Provider Demographics
NPI:1174989776
Name:SOULFUL HEALING, LLC
Entity type:Organization
Organization Name:SOULFUL HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMEEKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-917-1642
Mailing Address - Street 1:2442 E MAPLE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-4462
Mailing Address - Country:US
Mailing Address - Phone:810-208-2487
Mailing Address - Fax:810-652-8062
Practice Address - Street 1:4143 STONEBRIDGE
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-9531
Practice Address - Country:US
Practice Address - Phone:248-917-1642
Practice Address - Fax:810-652-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011782251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health