MEDICARE: SOLACE COUNSELING SERVICES INC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	170201	OTHER	CO	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972929420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLACE COUNSELING SERVICES INC

Provider Business Mailing Address
First Line	:	6655 W JEWELL AVE STE 100
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7108
Country	:	US
Telephone Number	:	303-975-1922
Fax Number	:	303-975-1918

Provider Business Practice Location Address
First Line	:	6655 W JEWELL AVE STE 100
Second Line	:
City	:	LAKEWOOD
State	:	CO
Zip	:	80232-7108
Country	:	US
Telephone Number	:	303-975-1922
Fax Number	:	303-975-1918

Authorized Official
Title or Position	:	OWNER
Name	:	MR. CHRISTOPHER J CONWAY
Credential	:	MA CAS
Telephone Number	:	303-669-0178

Provider Enumeration Date	:	03/07/2014
Last Update Date	:	09/19/2022

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