Provider Demographics
NPI:1083337760
Name:SOLI, LORI LEANNE (PHD LPCC ACS BCTMH)
Entity type:Individual
Prefix:DR
First Name:LORI
Middle Name:LEANNE
Last Name:SOLI
Suffix:
Gender:F
Credentials:PHD LPCC ACS BCTMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 WASHINGTON TER
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-1913
Mailing Address - Country:US
Mailing Address - Phone:858-952-9571
Mailing Address - Fax:
Practice Address - Street 1:10436 BAY AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843-2505
Practice Address - Country:US
Practice Address - Phone:858-952-9571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0017243101YP2500X
CA3112013101YP2500X
WI8663-125101YP2500X
MO2021018093101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional