=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255837811
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOLUTIONS PSYCHOTHERAPY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2018
-----------------------------------------------------
Last Update Date | 04/03/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20747 STERLINGTON DR
-----------------------------------------------------
City | LAND O LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34638-4317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-679-4885
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20747 STERLINGTON DR
-----------------------------------------------------
City | LAND O LAKES
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34638-4317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-679-4885
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OPERATOR
-----------------------------------------------------
Name | DR. LAUREN WOLF WEBER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 813-679-4885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0801X
-----------------------------------------------------
Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
License Number | PY10088
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------