Look up the most recent NPI and PECOS records

Enlightened Souls, Pllc

Counselor

Behavioral Health & Social Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Enlightened Souls, Pllc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 4:18 PM.

Profile Details

Provider ID
1063802908
Provider Type
Organization
Full Name
Enlightened Souls, Pllc

Subpart
No
Enumeration Date
1/30/2015
Last Updated
7/21/2022

Contact Information

Practice Location

501 Murphy Rd, Stafford, TX 77477-5417

(713) 539-5727

Unlisted Fax

Mailing Location

15818 Whiteglade Ln, Houston, TX 77084-6800

(713) 539-5727

Unlisted Fax

Authorized Official

Blue, Jasmine Dominique (Ceo)

(713) 539-5727

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 68068 Texas
Code 101YP2500X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer

Enlightened Souls, Pllc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Vandyke, Paula

Garcia, Christina Nicole

Carty, Neslyn Patricia

Washington, Shakyra Marie

Day, Robin Yvonne

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Rouze, Gloria Jean

Winchester, Vonica Renee

Mounts, Mark Alan

Sewell, Shirley Marie