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NPI 1891595955

NPI 1891595955 : SOLSTICE THERAPY : BALLY, PA

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General NPI Number Information
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    NPI Number           |    1891595955
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    Entity Type          |    Organization 
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    Legal Business Name  |    SOLSTICE THERAPY 
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Dates
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    Enumeration Date     |    03/18/2025
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    Last Update Date     |    03/18/2025
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Provider Practice Location Address
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    Address Line         |    20 N FRONT ST 
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    City                 |    BALLY
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    State                |    PA
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    Zip                  |    19503-9605
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    Country              |    US
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    Telephone            |    267-461-8831
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    20 N FRONT ST 
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    City                 |    BALLY
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    State                |    PA
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    Zip                  |    19503-9605
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     JACKIE  FOCHT 
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    Credential           |    
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    Telephone            |    267-461-8831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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