SOUL-FULL PRESENCE LLC - NPI 1871161190 - Psychologist in Middletown, DE

Q: What is Soul-Full Presence LLC's NPI number?

The NPI number for Soul-Full Presence LLC is 1871161190. It was assigned to this organization in the NPPES registry on June 14, 2021.

Q: What is Soul-Full Presence LLC's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

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About Soul-full Presence Llc NPPES

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

SOUL-FULL PRESENCE LLC (NPI 1871161190) is a healthcare organization registered as a clinical in Middletown, Delaware and active in the NPI registry since June 2021. The organization maintains a secondary practice location in Bear and lists Jessica L. L. Desrosiers, Clinical Psychologist, as its authorized official.

NPPES Registry Identity

NPI1871161190

Entity TypeOrganization

Primary Taxonomy103TC0700X

Legal Business NameSOUL-FULL PRESENCE LLC

Location Address101 W PARK PLMiddletown, DE 19709-1324

Mailing Address105 Nashua CtBear, DE 19701-3324 · (144) 361-7515

Phone(443) 617-5152

Fax(302) 376-6145

Organization SubpartNo

Authorized OfficialJessica L. L. DesrosiersClinical Psychologist · (443) 617-5152

Enumeration DateJune 14, 2021

NPPES CertifiedMay 24, 2021

✔ NPI 1871161190 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

101 W PARK PL, Middletown, DE 19709

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Secondary Practice Location 1

Location 1105 Nashua CtBear, DE 19701-3324 · Phone (443) 617-5152

Other Identifiers 2

Other1003096595DE · Medicare

Other471526DE · Medicare

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 13

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

MS. MARILYN LAWSON LCSW-C

Social Worker (Clinical)