Provider Demographics
NPI:1376063891
Name:GLORIA C SOLORZANO, LCSW, LLC
Entity Type:Organization
Organization Name:GLORIA C SOLORZANO, LCSW, LLC
Other - Org Name:GLORIA C SOLORZANO, LCSW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOLORZANO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:504-289-8047
Mailing Address - Street 1:12323 QUAGLINO RD
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:LA
Mailing Address - Zip Code:70437-7069
Mailing Address - Country:US
Mailing Address - Phone:985-796-3181
Mailing Address - Fax:985-796-3181
Practice Address - Street 1:5001 HIGHWAY 190 EAST SERVICE RD STE D4
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-4949
Practice Address - Country:US
Practice Address - Phone:504-289-8047
Practice Address - Fax:985-796-3181
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GLORIA C SOLORZANO, LCSW, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-26
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8998104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1104197698OtherINDIVIDUAL