Provider Demographics
NPI:1619278850
Name:SALOMON, NATACHA (LMHC, CAP, BSN, RN)
Entity Type:Individual
Prefix:
First Name:NATACHA
Middle Name:
Last Name:SALOMON
Suffix:
Gender:F
Credentials:LMHC, CAP, BSN, RN
Other - Prefix:
Other - First Name:NATACHA
Other - Middle Name:
Other - Last Name:SALOMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, CAP, BSN, RN,
Mailing Address - Street 1:7401 WILES RD # 111
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2036
Mailing Address - Country:US
Mailing Address - Phone:954-871-0463
Mailing Address - Fax:
Practice Address - Street 1:7401 WILES RD UNIT 111
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2036
Practice Address - Country:US
Practice Address - Phone:954-871-0463
Practice Address - Fax:954-869-4451
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4332101YA0400X
FLMH10218101YP2500X, 101YM0800X
FL9464694163WC0400X, 163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12613232OtherCAQH PROVIDER ID