MEDICARE: SOLACE THERAPY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
3	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1881252997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLACE THERAPY LLC

Provider Business Mailing Address
First Line	:	726 DALLAS ST
Second Line	:
City	:	PORT NECHES
State	:	TX
Zip	:	77651-2306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 FM 365
Second Line	:	SUITE 209A
City	:	NEDERLAND
State	:	TX
Zip	:	77627-6250
Country	:	US
Telephone Number	:	409-984-3016
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR/ PROGRAM DIRECTOR
Name	:	MRS. LATOYA MCCOY
Credential	:	BCBT, LBT,LCDC
Telephone Number	:	409-984-3016

Provider Enumeration Date	:	06/04/2019
Last Update Date	:	05/23/2025

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Directions to “SOLACE THERAPY LLC ” Practice Location

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