Provider Demographics
NPI:1891091443
Name:SOIN SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:SOIN SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SANGUTEI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-816-6704
Mailing Address - Street 1:PO BOX 13721
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-3721
Mailing Address - Country:US
Mailing Address - Phone:919-816-6704
Mailing Address - Fax:919-794-6110
Practice Address - Street 1:3711 UNIVERSITY DR
Practice Address - Street 2:SUITE 104B
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2654
Practice Address - Country:US
Practice Address - Phone:919-816-6704
Practice Address - Fax:919-794-6110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC006697251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6008366Medicaid