Provider Demographics
NPI:1851806855
Name:SOLIN PSYCHOLOGICAL & CONSULTATION SERVICES LLC
Entity Type:Organization
Organization Name:SOLIN PSYCHOLOGICAL & CONSULTATION SERVICES LLC
Other - Org Name:SPCS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD, LP
Authorized Official - Phone:651-757-7430
Mailing Address - Street 1:4252 BOULDER RIDGE PT
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-1899
Mailing Address - Country:US
Mailing Address - Phone:651-757-7430
Mailing Address - Fax:
Practice Address - Street 1:4660 SLATER RD STE 245C
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-4047
Practice Address - Country:US
Practice Address - Phone:651-757-7430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5907103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty