Healthcare Provider Details

I. General information

NPI: 1730070194
Provider Name (Legal Business Name): VERNA MICHELLE SOLES LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 HAZZARD CREEK VLG UNIT C
RIDGELAND SC
29936-8266
US

IV. Provider business mailing address

PO BOX 292
TABOR CITY NC
28463-0292
US

V. Phone/Fax

Practice location:
  • Phone: 843-645-7700
  • Fax: 888-908-7339
Mailing address:
  • Phone: 910-840-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA21066
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10503
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: