Provider Demographics
NPI:1306682190
Name:INTEGRATED SOUL CARE CONSULTANTS LLC
Entity type:Organization
Organization Name:INTEGRATED SOUL CARE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:VERONICA
Authorized Official - Last Name:SOMERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:954-588-8303
Mailing Address - Street 1:4522 NW 48TH TER
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3619
Mailing Address - Country:US
Mailing Address - Phone:954-588-8303
Mailing Address - Fax:
Practice Address - Street 1:8400 N UNIVERSITY DR STE 212
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-1700
Practice Address - Country:US
Practice Address - Phone:954-588-8303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty