# SOUL SURVIVOR COUNSELING SERVICES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1831502152
- **Authorized official:** MS. ANDREA MARTIN LPC, LPCC (PRESIDENT)
- **Authorized official phone:** (701) 258-2008

## Contact information

- **Practice address:** 1110 COLLEGE DR STE 206, BISMARCK, ND 58501-1207
- **Practice address phone:** (701) 258-2008
- **Practice address fax:** (701) 223-9114
- **Mailing address:** 1110 COLLEGE DR STE 206, BISMARCK, ND 58501-1207
- **Mailing address phone:** (701) 258-2008
- **Mailing address fax:** (701) 223-9114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 260-1-1-93-5T | ND | Yes |

## Other

- **Enumeration date:** 06/04/2014
- **Last updated:** 10/18/2022