Provider Demographics
NPI:1124497300
Name:SOLOMON, DAVID LAWRENCE (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LAWRENCE
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-4005
Mailing Address - Country:US
Mailing Address - Phone:270-860-9246
Mailing Address - Fax:
Practice Address - Street 1:230 2ND ST
Practice Address - Street 2:SUITE 407
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-3172
Practice Address - Country:US
Practice Address - Phone:270-826-8761
Practice Address - Fax:270-826-8737
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical