Provider Demographics
NPI:1952060022
Name:CELESTIN, SOLINE (CLINICAL COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:SOLINE
Middle Name:
Last Name:CELESTIN
Suffix:
Gender:F
Credentials:CLINICAL COUNSELOR
Other - Prefix:MRS
Other - First Name:SOLINE
Other - Middle Name:
Other - Last Name:LEROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COUNSELOR
Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-0289
Mailing Address - Country:US
Mailing Address - Phone:516-655-2661
Mailing Address - Fax:
Practice Address - Street 1:952 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4938
Practice Address - Country:US
Practice Address - Phone:516-655-2661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY20454101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral