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General NPI Number Information
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NPI Number | 1285379214
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Entity Type | Individual
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Provider Name | CLARA SOLES LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/04/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 1363 E LAFAYETTE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-4799
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Country | US
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Telephone | 850-296-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 6041 GA HIGHWAY 39 APT 8
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City | DONALSONVILLE
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State | GA
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Zip | 39845-6029
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Country | US
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Telephone | 352-406-4950
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH20682
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License Number State | FL
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