Provider Demographics
NPI:1902021785
Name:SOL PURPOSE LLC
Entity Type:Organization
Organization Name:SOL PURPOSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:ROCHELLE
Authorized Official - Last Name:BUCKLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-885-0992
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20604-0127
Mailing Address - Country:US
Mailing Address - Phone:301-885-0992
Mailing Address - Fax:301-885-0992
Practice Address - Street 1:2760 CRAIN HWY
Practice Address - Street 2:SUITE 406
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2804
Practice Address - Country:US
Practice Address - Phone:301-885-0992
Practice Address - Fax:301-885-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty