Provider Demographics
NPI:1033839949
Name:SINCERE SOLACE COUNSELING LLC
Entity Type:Organization
Organization Name:SINCERE SOLACE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER-BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:309-798-9555
Mailing Address - Street 1:2035 ELEPHANT WALK
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:MO
Mailing Address - Zip Code:63052-2183
Mailing Address - Country:US
Mailing Address - Phone:309-798-9555
Mailing Address - Fax:
Practice Address - Street 1:2035 ELEPHANT WALK
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:MO
Practice Address - Zip Code:63052-2183
Practice Address - Country:US
Practice Address - Phone:309-798-9555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)