Provider Demographics
NPI:1013407386
Name:SOLEIL, KATHERYN (LP)
Entity Type:Individual
Prefix:
First Name:KATHERYN
Middle Name:
Last Name:SOLEIL
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 DIKEMAN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-1532
Mailing Address - Country:US
Mailing Address - Phone:718-360-8624
Mailing Address - Fax:
Practice Address - Street 1:1123 BROADWAY STE 923
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2007
Practice Address - Country:US
Practice Address - Phone:347-545-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001020102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst