=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023686490
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SIMONE HAWTHORNE SOLLISCH LPCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/14/2021
-----------------------------------------------------
Last Update Date | 08/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3500 CARNEGIE AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44115-2641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-260-8300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20545 CENTER RIDGE RD STE 448
-----------------------------------------------------
City | ROCKY RIVER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44116-3423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 440-356-0083
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | C.2103250-TRNE
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | E.2505459
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------