Provider Demographics
NPI:1689009664
Name:SOLSTICE COUNSELING & CONSULTATION SERVICES
Entity Type:Organization
Organization Name:SOLSTICE COUNSELING & CONSULTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:J
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S LICDC SAP
Authorized Official - Phone:216-321-1833
Mailing Address - Street 1:1089 HILLROCK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3852
Mailing Address - Country:US
Mailing Address - Phone:216-321-1833
Mailing Address - Fax:216-321-1866
Practice Address - Street 1:14077 CEDAR RD
Practice Address - Street 2:SUITE LL2
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44118-3338
Practice Address - Country:US
Practice Address - Phone:216-321-1833
Practice Address - Fax:216-321-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLCDC.121124-3101YA0400X
OHE.1000153101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty