Organization
SOUL-RENITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIER M JOHNSON LCPC, MS, NCC (OWNER)
(443) 869-6584
Entity
Organization
Contact information
Practice address
3602 MOHAWK AVE, SUITE 200, BALTIMORE, MD 21207-7665
(443) 869-6584
(443) 869-6127
Mailing address
1800 N CHARLES ST, SUITE 204, BALTIMORE, MD 21201-5920
(443) 869-6584
(443) 869-6127
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2447
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024537200
—
MD
05
—
062137400
—
MD
05
—
304800400
—
MD
Enumeration date
11/25/2014
Last updated
11/19/2015
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