Provider Demographics
NPI:1356088868
Name:SOL COUNSELING AND WELLNESS STUDIO, LLC
Entity Type:Organization
Organization Name:SOL COUNSELING AND WELLNESS STUDIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-336-5049
Mailing Address - Street 1:312 S CEDROS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1943
Mailing Address - Country:US
Mailing Address - Phone:760-741-9799
Mailing Address - Fax:
Practice Address - Street 1:312 S CEDROS AVE STE 300
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1943
Practice Address - Country:US
Practice Address - Phone:760-741-9799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty