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SOUL SHINE CHILDREN'S TREATMENT SERVICES INC. NPI 1982818399


NPI Information

NPI: 1982818399
Provider Name: SOUL SHINE CHILDREN'S TREATMENT SERVICES, INC.
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
218 E 2ND AVE
RED SPRINGS, NC
ZIP 28377
Phone: (910) 536-6094
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SOUL SHINE CHILDREN'S TREATMENT SERVICES, INC. is a clinical social worker in Red Springs, NC. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SOUL SHINE CHILDREN'S TREATMENT SERVICES, INC. NPI is 1982818399. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

218 E 2ND AVE
RED SPRINGS, NC
ZIP 28377-308
Phone: (910) 536-6094
Fax: (910) 843-9728

The provider's authorized official is Leshia Rogers Deese .
The authorized official title is Owner and has the following contact phone number (910) 536-6094.

The enumeration date for this NPI number is 5/9/2007 and was last updated on 7/9/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)LCAS-21969NORTH CAROLINANo
21041C0700XSocial WorkerClinicalC005175NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16106174MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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