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Organization
WISE SOUL LLC
Active
Organization
WISE SOUL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FELIPE MERCADO EDD, MSW, PPSC, ASW (CEO/LEAD CONSULTANT/CLINICIAN)
(559) 759-2790
Entity
Organization
Contact information
Practice address
6405 E BUTLER AVE, FRESNO, CA 93727-5709
(559) 759-2790
Mailing address
6405 E BUTLER AVE, FRESNO, CA 93727-5709
(559) 759-2790
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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