| Soulshine Counseling Services, Llc | |
|
215 Industrial Rd Sylvania GA 30467-1866 | |
| (912) 209-5941 | |
| (912) 567-3600 |
| Full Name | Soulshine Counseling Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 215 Industrial Rd, Sylvania, Georgia |
| Authorized Official Name and Position | K. Michelle Ware (OWNER) |
| Authorized Official Contact | 9122095941 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soulshine Counseling Services, Llc Po Box 1982 Sylvania GA 30467-7182 Ph: () - | Soulshine Counseling Services, Llc 215 Industrial Rd Sylvania GA 30467-1866 Ph: (912) 209-5941 |
| NPI Number | 1447823976 |
|---|---|
| Provider Enumeration Date | 07/22/2021 |
| Last Update Date | 03/10/2025 |
| Certification Date | 03/10/2025 |
| Medicare PECOS PAC ID | 7315380672 |
|---|---|
| Medicare Enrollment ID | O20240205000206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447823976 | NPI | - | NPPES |
| 0032339621 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Karen Ware |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1730591314 PECOS PAC ID: 8224471586 Enrollment ID: I20240205000640 |
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