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General NPI Number Information
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NPI Number | 1851199517
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Entity Type | Organization
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Legal Business Name | SOLACE THERAPY SERVICES LLC
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Dates
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Enumeration Date | 03/06/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 4121 UNION RD STE 225
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City | SAINT LOUIS
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State | MO
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Zip | 63129-1093
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Country | US
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Telephone | 605-261-0753
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Fax |
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Provider Business Mailing Address
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Address Line | 5527 WINONA AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63109-1648
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Country | US
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Telephone | 605-261-0753
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | KILEY LYNN ASCHOFF
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Credential |
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Telephone | 605-261-0753
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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