Provider Demographics
NPI:1508553710
Name:SOLUNA COUNSELING LLC
Entity Type:Organization
Organization Name:SOLUNA COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH CLINICIAN (OWNER)
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:CASTILLO
Authorized Official - Last Name:TIZABI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:240-678-6396
Mailing Address - Street 1:8609 2ND AVE STE 404B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3374
Mailing Address - Country:US
Mailing Address - Phone:240-678-6396
Mailing Address - Fax:
Practice Address - Street 1:8609 2ND AVE STE 404B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3374
Practice Address - Country:US
Practice Address - Phone:240-678-6396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty