Organization
THE SOUL REMEDIATION CENTER LLC
Active
Organization
THE SOUL REMEDIATION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEAN GLEN OLIVER BAXTER LICSW (OWNER)
(202) 751-6444
Entity
Organization
Contact information
Practice address
1629 K ST NW, WASHINGTON, DC 20006-1602
(202) 751-6444
Mailing address
2513 WEST ST SE, WASHINGTON, DC 20020-4414
(202) 751-6444
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/05/2019
Last updated
12/30/2024
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