Provider Demographics
NPI:1518101906
Name:SOLUTIONS COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:SOLUTIONS COUNSELING SERVICES, PLLC
Other - Org Name:SOLUTIONS COUNSELING & CASE MANAGEMENT SERVICES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DELTON
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:DE VOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, CRC
Authorized Official - Phone:919-381-5703
Mailing Address - Street 1:2314 S MIAMI BLVD
Mailing Address - Street 2:SUITE 154
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-5793
Mailing Address - Country:US
Mailing Address - Phone:919-381-5703
Mailing Address - Fax:919-381-5701
Practice Address - Street 1:506 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-4103
Practice Address - Country:US
Practice Address - Phone:919-381-5703
Practice Address - Fax:919-381-5701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4985101YP2500X
NCC0062491041C0700X
NC2001-001462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006092Medicaid