MEDICARE: MONDE SOLOMON MSW, SWLC

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	101YM0800X	Mental Health Counselor		MT

General Provider Information

NPI Number	:	1699431692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONDE SOLOMON MSW, SWLC

Provider Business Mailing Address
First Line	:	1925 GRAND AVE STE 114
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-2762
Country	:	US
Telephone Number	:	406-598-9568
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 GRAND AVE STE 114
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-2762
Country	:	US
Telephone Number	:	406-598-9568
Fax Number	:

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

Provider Enumeration Date	:	11/13/2021
Last Update Date	:	05/13/2022

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