MEDICARE: DIARA SOLITE MS, NCC, LPC, LCDC-I

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	86300	TX
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1861906984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIARA SOLITE MS, NCC, LPC, LCDC-I

Provider Business Mailing Address
First Line	:	58155 CHINN ST
Second Line	:
City	:	PLAQUEMINE
State	:	LA
Zip	:	70764-3601
Country	:	US
Telephone Number	:	225-385-4543
Fax Number	:

Provider Business Practice Location Address
First Line	:	4825 ALLIANCE BLVD STE 150
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-5504
Country	:	US
Telephone Number	:	844-824-8775
Fax Number	:

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

Provider Enumeration Date	:	11/28/2017
Last Update Date	:	08/18/2023

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