Healthcare Provider Details

I. General information

NPI: 1639334857
Provider Name (Legal Business Name): SOLOMON WELLS LMHC, LPC, CASAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 SICKLES ST APT 4I
NEW YORK NY
10040-1833
US

IV. Provider business mailing address

44 SICKLES ST APT 4I
NEW YORK NY
10040-1833
US

V. Phone/Fax

Practice location:
  • Phone: 917-684-8100
  • Fax: 212-239-0948
Mailing address:
  • Phone: 917-684-8100
  • Fax: 646-360-4004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01079900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number19640
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6473
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005017
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: