MEDICARE: MRS. JULIE STACY SOLARSH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	017998	NY

General Provider Information

NPI Number	:	1174131387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE STACY SOLARSH

Provider Business Mailing Address
First Line	:	3305 JERUSALEM AVE STE 207
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-2219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 JERUSALEM AVE STE 207
Second Line	:
City	:	WANTAGH
State	:	NY
Zip	:	11793-2028
Country	:	US
Telephone Number	:	516-884-7742
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	06/02/2026

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