Healthcare Provider Details

I. General information

NPI: 1114840972
Provider Name (Legal Business Name): SOLENNE WELLNESS INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 W MAIN ST
LEXINGTON KY
40508-2020
US

IV. Provider business mailing address

1860 BENTON PL
LEXINGTON KY
40505-1676
US

V. Phone/Fax

Practice location:
  • Phone: 859-285-4768
  • Fax:
Mailing address:
  • Phone: 859-285-4768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BROOKE LAMETTA JOHNSON
Title or Position: OWNER
Credential:
Phone: 859-285-4768