Healthcare Provider Details

I. General information

NPI: 1093571531
Provider Name (Legal Business Name): ALEXANDRA SOLIS MSW, LACC, LCSWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 S 1ST ST
BENNETT CO
80102-7860
US

IV. Provider business mailing address

190 S 1ST ST
BENNETT CO
80102-7860
US

V. Phone/Fax

Practice location:
  • Phone: 303-644-4240
  • Fax:
Mailing address:
  • Phone: 303-644-4240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: