MEDICARE: MS. CELIA C SOLOMON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	LPC000363	GA

General Provider Information

NPI Number	:	1225117849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CELIA C SOLOMON LPC

Provider Business Mailing Address
First Line	:	1661 13TH ST
Second Line	:	SUITE 102
City	:	COLUMBUS
State	:	GA
Zip	:	31901
Country	:	US
Telephone Number	:	706-323-4077
Fax Number	:	706-324-2088

Provider Business Practice Location Address
First Line	:	1661 13TH ST
Second Line	:	SUITE 102
City	:	COLUMBUS
State	:	GA
Zip	:	31901
Country	:	US
Telephone Number	:	706-323-4077
Fax Number	:	706-324-2088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/08/2007

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