Healthcare Provider Details

I. General information

NPI: 1922257393
Provider Name (Legal Business Name): ADA LOUISE SOLOMON LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 WILLISTON AVE
EASTHAMPTON MA
01027-2252
US

IV. Provider business mailing address

78 WILLISTON AVE
EASTHAMPTON MA
01027-2252
US

V. Phone/Fax

Practice location:
  • Phone: 617-512-3056
  • Fax:
Mailing address:
  • Phone: 617-512-3056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116991
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: