Provider Demographics
NPI:1699431692
Name:SOLOMON, MONDE (MSW, SWLC)
Entity type:Individual
Prefix:
First Name:MONDE
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:MSW, SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 GRAND AVE STE 114
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2762
Mailing Address - Country:US
Mailing Address - Phone:406-598-9568
Mailing Address - Fax:
Practice Address - Street 1:1925 GRAND AVE STE 114
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2762
Practice Address - Country:US
Practice Address - Phone:406-598-9568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health