Provider Demographics
NPI:1922581537
Name:SOLID GROUND COUNSELING AND THERAPY SERVICES INC
Entity Type:Organization
Organization Name:SOLID GROUND COUNSELING AND THERAPY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:ALTAMIRANO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:512-576-9772
Mailing Address - Street 1:1120 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-4603
Mailing Address - Country:US
Mailing Address - Phone:125-576-9772
Mailing Address - Fax:
Practice Address - Street 1:1120 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-4603
Practice Address - Country:US
Practice Address - Phone:512-576-9772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health