Healthcare Provider Details

I. General information

NPI: 1043149610
Provider Name (Legal Business Name): SOLACE COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 2ND AVE
COLUMBUS OH
43201-3623
US

IV. Provider business mailing address

313 GRACELAND BLVD
COLUMBUS OH
43214-3554
US

V. Phone/Fax

Practice location:
  • Phone: 614-434-6342
  • Fax:
Mailing address:
  • Phone: 614-434-6342
  • 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: AMANDA TILLMAN
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LPCC
Phone: 614-434-6342