MEDICARE: SOLIDARITYEE, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	171M00000X	Case Manager/Care Coordinator
3	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1629724349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLIDARITYEE, PLLC

Provider Business Mailing Address
First Line	:	2908 SILHOUETTE BAY DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3470
Country	:	US
Telephone Number	:	409-210-9717
Fax Number	:

Provider Business Practice Location Address
First Line	:	2908 SILHOUETTE BAY DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3470
Country	:	US
Telephone Number	:	409-210-9717
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KANDI ROKEYSHA BRISCOE
Credential	:	LCSW-S
Telephone Number	:	409-210-9717

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	09/25/2023

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