Provider Demographics
NPI:1649525338
Name:SOLOMONS, AUSTIN DOUGLAS (LCSW)
Entity type:Individual
Prefix:MR
First Name:AUSTIN
Middle Name:DOUGLAS
Last Name:SOLOMONS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-6111
Mailing Address - Country:US
Mailing Address - Phone:580-504-1179
Mailing Address - Fax:
Practice Address - Street 1:82 MEDICAL GROUP
Practice Address - Street 2:149 HART STREET
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311
Practice Address - Country:US
Practice Address - Phone:940-676-3895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical