Provider Demographics
NPI:1558609164
Name:SOLON-GOERS, MARY K (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:K
Last Name:SOLON-GOERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3478 THYME DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-5385
Mailing Address - Country:US
Mailing Address - Phone:815-222-4305
Mailing Address - Fax:815-399-5767
Practice Address - Street 1:3478 THYME DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-5385
Practice Address - Country:US
Practice Address - Phone:815-222-4305
Practice Address - Fax:815-399-5767
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0013171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical