Provider Demographics
NPI:1396632295
Name:ENDURING SOUL LLC
Entity type:Organization
Organization Name:ENDURING SOUL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:523-630-2022
Mailing Address - Street 1:2608 N MAIN ST STE B112
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-1546
Mailing Address - Country:US
Mailing Address - Phone:512-630-2022
Mailing Address - Fax:
Practice Address - Street 1:2608 N MAIN ST STE B112
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1546
Practice Address - Country:US
Practice Address - Phone:512-630-2022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health