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Organization
SOULFUL SOMATICS LICENSED CLINICAL SOCIAL WORKER PC
Active
Organization
SOULFUL SOMATICS LICENSED CLINICAL SOCIAL WORKER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISRIN BROOKE FREE LCSW (CEO/OWNER)
(530) 354-0455
Entity
Organization
Contact information
Practice address
4 GOVERNORS LN STE C, CHICO, CA 95926-5514
(530) 531-3459
(844) 525-7544
Mailing address
4 GOVERNORS LN STE C, CHICO, CA 95926-5514
(530) 531-3459
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
592984
—
CA
Enumeration date
12/29/2022
Last updated
12/29/2022
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