Provider Demographics
NPI:1215570635
Name:SOLA, ADAM THOMAS (LCSW)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:THOMAS
Last Name:SOLA
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 1:345 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1824
Mailing Address - Country:US
Mailing Address - Phone:860-525-2181
Mailing Address - Fax:860-525-7332
Practice Address - Street 1:345 MAIN ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1824
Practice Address - Country:US
Practice Address - Phone:860-525-2181
Practice Address - Fax:860-525-7332
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT103431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty