Provider Demographics
NPI:1316224868
Name:SOLES, ELLEN (LPC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:SOLES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 W BEEBE CAPPS EXPY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-5169
Mailing Address - Country:US
Mailing Address - Phone:501-279-9220
Mailing Address - Fax:501-279-9220
Practice Address - Street 1:1554 W BEEBE CAPPS EXPY
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-5169
Practice Address - Country:US
Practice Address - Phone:501-279-9220
Practice Address - Fax:501-279-9220
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1503032101YP2500X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR187856795Medicaid