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General NPI Number Information
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NPI Number | 1912673799
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Entity Type | Organization
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Legal Business Name | SOLSTICE MENTAL HEALTH, A LICENSED CLINICAL SOCIAL WORKER PC
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 4730 N SACRAMENTO AVE
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City | CHICAGO
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State | IL
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Zip | 60625-4306
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Country | US
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Telephone | 424-284-9325
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Fax |
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Provider Business Mailing Address
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Address Line | 7190 W SUNSET BLVD # 40F
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City | LOS ANGELES
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State | CA
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Zip | 90046-4415
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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 | PRESIDENT
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Name | JAMES SEARING
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Credential | LCSW
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Telephone | 312-953-8395
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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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