Provider Demographics
NPI:1689726309
Name:SOLOMON, LAURA J (CSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:J
Other - Last Name:SOLOMON-BOHUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2570 ROUTE 9W STE 10
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-1370
Mailing Address - Country:US
Mailing Address - Phone:845-220-3100
Mailing Address - Fax:845-534-2940
Practice Address - Street 1:35 FELTERS RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-2600
Practice Address - Country:US
Practice Address - Phone:607-201-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0748321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical