Provider Demographics
NPI:1851269864
Name:BODY MIND SOUL HEALING LLC
Entity type:Organization
Organization Name:BODY MIND SOUL HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORENIKE
Authorized Official - Middle Name:NAOMI SALONE
Authorized Official - Last Name:OLORUNNISOMO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:469-200-3419
Mailing Address - Street 1:2410 MYSTIC TRL
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-2428
Mailing Address - Country:US
Mailing Address - Phone:214-616-0084
Mailing Address - Fax:
Practice Address - Street 1:2410 MYSTIC TRL
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-2428
Practice Address - Country:US
Practice Address - Phone:214-616-0084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty