Provider Demographics
NPI:1902411499
Name:SOLARI MENTAL AND BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:SOLARI MENTAL AND BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:CAMERON-MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP-PMHNP-BC, NP
Authorized Official - Phone:704-936-0200
Mailing Address - Street 1:5500 EXECUTIVE CENTER DR STE 235
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-8821
Mailing Address - Country:US
Mailing Address - Phone:704-936-0200
Mailing Address - Fax:704-936-0226
Practice Address - Street 1:5500 EXECUTIVE CENTER DR STE 235
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8821
Practice Address - Country:US
Practice Address - Phone:704-936-0200
Practice Address - Fax:704-936-0226
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1902411499OtherMENTAL HEALTH
NC1326541574Medicaid