Provider Demographics
NPI:1881025807
Name:SOLACE CHATEAU LLC
Entity Type:Organization
Organization Name:SOLACE CHATEAU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT, LPC-S, CIMHP
Authorized Official - Phone:504-656-4284
Mailing Address - Street 1:PO BOX 56811
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70156-6811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2305 N HULLEN ST STE 11
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1988
Practice Address - Country:US
Practice Address - Phone:504-656-4284
Practice Address - Fax:866-652-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-01
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5226101Y00000X
101YP2500X, 261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth ServiceGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1629198395OtherNPI