Healthcare Provider Details

I. General information

NPI: 1548992811
Provider Name (Legal Business Name): SOLSTICE BEHAVIORAL HEALTH & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ENTERPRISE DR
SHELTON CT
06484-4631
US

IV. Provider business mailing address

1 ENTERPRISE DR
SHELTON CT
06484-4631
US

V. Phone/Fax

Practice location:
  • Phone: 203-554-0763
  • Fax:
Mailing address:
  • Phone: 203-554-0763
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: SARAH WISLOCKI
Title or Position: BEHAVIOR ANALYST
Credential: BCBA
Phone: 203-525-7212