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Organization

SOUL PSYCHED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBORAH ANN SAMPSON LPC (OWNER)
(920) 358-0582
Entity
Organization

Contact information

Practice address
1477 KENWOOD DR STE 200, MENASHA, WI 54952-1160
(920) 358-0582
Mailing address
1477 KENWOOD DR STE 200, MENASHA, WI 54952-1160
(920) 358-0582

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
04/08/2026
Last updated
04/08/2026
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