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

Soul Renewal Therapy LLC

Organization Clinical Social Worker · NPI 1417759655

Soul Renewal Therapy LLC is a Clinical Social Worker in Riverside, Illinois. Registered with an NPI since 2025.

In the registry since
2025
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

338 Lawton Rd
Riverside, IL 60546-2359
Phone: (605) 380-0349
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1417759655
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amy Kienow Paychek — Lcsw · (605) 380-0349
NPI enumeratedMarch 26, 2025
Last updated in NPPESMarch 26, 2025
Certification dateMarch 26, 2025
Mailing address338 Lawton Rd, Riverside, IL 60546-2359

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