=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215886007
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SOLOMON D. LEONARD JR.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/24/2026
-----------------------------------------------------
Last Update Date | 01/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 258 SPIELMAN HWY
-----------------------------------------------------
City | BURLINGTON
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06013-1723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-368-8665
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 56 WHITING ST UNIT 846
-----------------------------------------------------
City | PLAINVILLE
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06062-7734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-368-8665
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 4101
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------