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Organization
SOUL CARE SOLUTION LLC
Active
Organization
SOUL CARE SOLUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CYNTHIA LEE CHAUSSE ED.D. L.M.H.C. (DIRECTOR/CLINICIAN)
(941) 235-7215
Entity
Organization
Contact information
Practice address
17825 MURDOCK CIR STE 1B, PORT CHARLOTTE, FL 33948-4000
(941) 235-7215
(941) 255-5055
Mailing address
17825 MURDOCK CIR STE 1B, PORT CHARLOTTE, FL 33948-4000
(941) 235-7215
(941) 255-5055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH3566
FL
101YP2500X
Professional Counselor
MH3566
FL
101YS0200X
School Counselor
MH3566
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265818769
NPI INDIVIDUAL TYPE 1
FL
01
—
MH3566
MENTAL HEALTH COUNSELOR
FL
Enumeration date
11/28/2017
Last updated
11/28/2017
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