Provider Demographics
NPI:1912374059
Name:OGUINE, SOLOMON (LCPC)
Entity Type:Individual
Prefix:
First Name:SOLOMON
Middle Name:
Last Name:OGUINE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 WHITE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3413
Mailing Address - Country:US
Mailing Address - Phone:443-801-6790
Mailing Address - Fax:410-254-0313
Practice Address - Street 1:3613 WHITE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-3413
Practice Address - Country:US
Practice Address - Phone:443-801-6790
Practice Address - Fax:410-254-0313
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6537101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional