Provider Demographics
NPI:1629944335
Name:SOLARA MIND BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:SOLARA MIND BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERLOS CHINDONGO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP-BC
Authorized Official - Phone:857-919-2945
Mailing Address - Street 1:4 STONE LN APT 5147
Mailing Address - Street 2:
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-1573
Mailing Address - Country:US
Mailing Address - Phone:857-919-2945
Mailing Address - Fax:
Practice Address - Street 1:578 MAIN STREET
Practice Address - Street 2:UNIT 202B
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148
Practice Address - Country:US
Practice Address - Phone:857-919-2945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-11
Last Update Date:2025-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty