Provider Demographics
NPI:1972929420
Name:SOLACE COUNSELING SERVICES INC
Entity Type:Organization
Organization Name:SOLACE COUNSELING SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:CONWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MA CAS
Authorized Official - Phone:303-669-0178
Mailing Address - Street 1:6655 W JEWELL AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-7108
Mailing Address - Country:US
Mailing Address - Phone:303-975-1922
Mailing Address - Fax:303-975-1918
Practice Address - Street 1:6655 W JEWELL AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7108
Practice Address - Country:US
Practice Address - Phone:303-975-1922
Practice Address - Fax:303-975-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-07
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO170201OtherLICENSE
CO9000152260Medicaid