Innersoul Collective LLC

NPI #1003623869 in Champaign, Illinois

Provider Information

NPI Number: 1003623869
Entity Type: Organization
Organization Name: Innersoul Collective LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Dec 16, 2024
Last Updated: Jan 13, 2025

Practice Location

Address: 2604 HUNTERS POND RUN APT 32
City: Champaign
State: Illinois
ZIP Code: 61820-2664
Phone: (773) 234-6869

Authorized Official

Name: CASHONNA BERGER
Title: CREDENTIALING SPECIALIST
Phone: (217) 799-1809

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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