| Soul Care Therapy Llc | |
|
2403 S 133rd Plz Omaha NE 68144-5905 | |
| (402) 203-4407 | |
| Not Available |
| Full Name | Soul Care Therapy Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2403 S 133rd Plz, Omaha, Nebraska |
| Authorized Official Name and Position | Kelli Stoffer (THERAPIST) |
| Authorized Official Contact | 4022034407 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Care Therapy Llc 2403 S 133rd Plz Omaha NE 68144-5905 Ph: (402) 203-4407 | Soul Care Therapy Llc 2403 S 133rd Plz Omaha NE 68144-5905 Ph: (402) 203-4407 |
| NPI Number | 1508553728 |
|---|---|
| Provider Enumeration Date | 04/18/2023 |
| Last Update Date | 04/18/2023 |
| Certification Date | 04/18/2023 |
| Medicare PECOS PAC ID | 1355706755 |
|---|---|
| Medicare Enrollment ID | O20230507000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508553728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kelli J Stoffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679933725 PECOS PAC ID: 5395042584 Enrollment ID: I20160404000749 |
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