Soul Renewal Therapy LLC

NPI #1417759655 in Riverside, Illinois

Provider Information

NPI Number: 1417759655
Entity Type: Organization
Organization Name: Soul Renewal Therapy LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Mar 26, 2025
Last Updated: Mar 26, 2025

Practice Location

Address: 338 LAWTON RD
City: Riverside
State: Illinois
ZIP Code: 60546-2359
Phone: (605) 380-0349

Authorized Official

Name: AMY KIENOW PAYCHEK
Title: LCSW
Phone: (605) 380-0349

Specialties & Taxonomy Codes

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

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