Provider Demographics
NPI:1215612650
Name:SOLO THERAPY
Entity type:Organization
Organization Name:SOLO THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LYSSA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SOLOMON SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-553-3597
Mailing Address - Street 1:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:REDAN
Mailing Address - State:GA
Mailing Address - Zip Code:30074-1124
Mailing Address - Country:US
Mailing Address - Phone:404-553-3597
Mailing Address - Fax:
Practice Address - Street 1:1400 SOUTHLAKE PLAZA DR
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1756
Practice Address - Country:US
Practice Address - Phone:404-553-3597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty