Provider Demographics
NPI:1558510339
Name:SOLOMON, YVONNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5778 WAYMAN CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27823-8793
Mailing Address - Country:US
Mailing Address - Phone:252-813-8785
Mailing Address - Fax:
Practice Address - Street 1:608 JACKSON STREET
Practice Address - Street 2:SUITE B
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870
Practice Address - Country:US
Practice Address - Phone:252-813-8785
Practice Address - Fax:252-537-0329
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7951101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6006346OtherBUSINESS MEDICAID NUMBER
NC6104025Medicaid
NC1285805622OtherBUSINESS NPI