=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104730357
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOLSTICE THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/02/2026
-----------------------------------------------------
Last Update Date | 10/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 ALLEN TOUSSAINT BLVD
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70124-2537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-360-9580
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 ALLEN TOUSSAINT BLVD
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70124-2537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-360-9580
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/SOCIAL WORKER
-----------------------------------------------------
Name | DR. KELLY NICOLE ANDERSON
-----------------------------------------------------
Credential | MSW, DSW, LCSW
-----------------------------------------------------
Telephone | 504-360-9580
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------