Provider Demographics
NPI:1477855336
Name:HEARD, SOLCOLLIN ALISCIA (MED, LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SOLCOLLIN
Middle Name:ALISCIA
Last Name:HEARD
Suffix:
Gender:F
Credentials:MED, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 W MORRISON ST
Mailing Address - Street 2:STE. 18
Mailing Address - City:FAYETTE
Mailing Address - State:MO
Mailing Address - Zip Code:65248-1075
Mailing Address - Country:US
Mailing Address - Phone:573-228-0264
Mailing Address - Fax:660-248-3088
Practice Address - Street 1:600 W MORRISON ST
Practice Address - Street 2:STE. 18
Practice Address - City:FAYETTE
Practice Address - State:MO
Practice Address - Zip Code:65248-1075
Practice Address - Country:US
Practice Address - Phone:573-228-0264
Practice Address - Fax:660-248-3088
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-29
Last Update Date:2016-09-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010039179101YP2500X
MO2014038233106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist