Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Self-Soulstice, LLC

Organization Professional Counselor · NPI 1477959807

Self-Soulstice, LLC is a Professional Counselor in Statesboro, Georgia. Licensed in Georgia. Registered with an NPI since 2014.

Licensed in
GA
In the registry since
2014
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

114 N College St
Statesboro, GA 30458-5309
Phone: (912) 755-7069
Fax: (912) 480-9733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC005007 (GA)

Record details

NPI number1477959807
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official D Bates — Owner · (912) 755-7069
NPI enumeratedNovember 12, 2014
Last updated in NPPESNovember 12, 2014
Mailing address111 Hawthorne Rd, Statesboro, GA 30458-6003

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