Provider Demographics
NPI:1770098824
Name:SOLOMON, CHERELLE JOSETTE SHENISSE (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:CHERELLE
Middle Name:JOSETTE SHENISSE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 W 126TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-1202
Mailing Address - Country:US
Mailing Address - Phone:203-598-8081
Mailing Address - Fax:
Practice Address - Street 1:3737 MARTIN LUTHER KING JR BLVD STE 550
Practice Address - Street 2:
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-3536
Practice Address - Country:US
Practice Address - Phone:323-249-2950
Practice Address - Fax:310-609-0301
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW749401041C0700X
CALCS907581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical