Provider Demographics
NPI:1740866417
Name:SOLANO, ANTHONY (LCPC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:SOLANO
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:PO BOX 2551
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-2551
Mailing Address - Country:US
Mailing Address - Phone:301-275-7665
Mailing Address - Fax:
Practice Address - Street 1:20424 WATERS POINT LN
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1067
Practice Address - Country:US
Practice Address - Phone:301-275-7665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180004216101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional