Organization
SOULMINE LLC
Active
Other names
SoulMine Destinations
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHANDRA GREEN LMFT (CEO / HEAD THERAPIST & FACILITATOR)
(913) 303-9868
Entity
Organization
Contact information
Practice address
1121 N. 5TH STREET, SUITE 109, KANSAS CITY, KS 66101
(913) 303-9868
Mailing address
1121 N. 5TH STREET, SUITE 109, KANSAS CITY, KS 66101
(913) 303-9868
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
251K00000X
Public Health or Welfare Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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