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SOUL APOTHECARY, LLC
NPI 1417699471
Clinic/Center - Adult Mental Health in O Fallon, IL

Active since April 11, 2022
787 SUNSET BLVD, O FALLON, IL 62269(618) 292-8964 Get Directions Write a Review

NPPES record last updated: January 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 9, 2023, Apr 19, 2022, Apr 11, 2022 (3 updates tracked since 2022).

About Soul Apothecary, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUL APOTHECARY, LLC (NPI 1417699471) is a healthcare organization registered as an adult mental health in O Fallon, Illinois and active in the NPI registry since April 2022. The organization lists Mallory Prindable, Mental Health Therapist/owner, as its authorized official.

NPPES Registry Identity

NPI1417699471
Entity TypeOrganization
Primary Taxonomy261QM0850X
Legal Business NameSOUL APOTHECARY, LLC
Location Address787 SUNSET BLVDO Fallon, IL 62269-1960
Mailing Address306 Emily CirO Fallon, IL 62269-1301 · (618) 292-8964
Phone(618) 292-8964
Organization SubpartNo
Authorized OfficialMallory PrindableMental Health Therapist/owner · (618) 292-8964
Enumeration DateApril 11, 2022
Last NPPES UpdateJanuary 9, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 9, 2023
✔ NPI 1417699471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Adult Mental HealthAmbulatory Health Care Facilities
Taxonomy Code261QM0850X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X
787 SUNSET BLVD, O Fallon, IL 62269
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SCOTT ROBERT UNDERWOOD D.C.
Chiropractor
787 SUNSET BLVD, SUITE 200
O FALLON, IL 62269
St. Clair County (618) 624-2400
UNDERWOOD CHIROPRACTIC L.L.C.
Chiropractor
787 SUNSET BLVD, SUITE 200
O FALLON, IL 62269
St. Clair County (618) 624-2400
MRS. MALLORY ANN COOK MSW, LCSW
Social Worker (Clinical)
787 SUNSET BLVD
O FALLON, IL 62269
St. Clair County (618) 292-8964

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Soul Apothecary, LLC's NPI number?

The NPI number for Soul Apothecary, LLC is 1417699471. It was assigned to this organization in the NPPES registry on April 11, 2022.

Where is Soul Apothecary, LLC located?

Soul Apothecary, LLC is located at 787 Sunset Blvd, O Fallon, IL 62269. The listed phone number is (618) 292-8964.

What is Soul Apothecary, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Adult Mental Health, with taxonomy code 261QM0850X.

When was this NPI record last updated?

The NPPES record for Soul Apothecary, LLC was last updated on January 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.