Provider Demographics
NPI:1811539752
Name:SOLOWAY, SOPHIA MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MAE
Last Name:SOLOWAY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 AMITY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6286
Mailing Address - Country:US
Mailing Address - Phone:917-232-8220
Mailing Address - Fax:
Practice Address - Street 1:203 AMITY ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-6286
Practice Address - Country:US
Practice Address - Phone:917-232-8220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0881141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical