Provider Demographics
NPI:1710270517
Name:SOLOMON, BEVERLY HELEN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:HELEN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 E GUNN RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1928
Mailing Address - Country:US
Mailing Address - Phone:248-652-3164
Mailing Address - Fax:
Practice Address - Street 1:1940 E GUNN RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48306-1928
Practice Address - Country:US
Practice Address - Phone:248-652-3164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010159331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical