Provider Demographics
NPI:1609472075
Name:SOLID FOUNDATION COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:SOLID FOUNDATION COUNSELING SERVICES LLC
Other - Org Name:IVAN QUAN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:QUAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-614-1407
Mailing Address - Street 1:109 LAURENS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1860
Mailing Address - Country:US
Mailing Address - Phone:864-614-1407
Mailing Address - Fax:
Practice Address - Street 1:207 W ANTRIM DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2329
Practice Address - Country:US
Practice Address - Phone:864-614-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty