Provider Demographics
NPI:1780436253
Name:SOLIS PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:SOLIS PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:231-838-3074
Mailing Address - Street 1:616 PETOSKEY ST STE 403
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2700
Mailing Address - Country:US
Mailing Address - Phone:231-714-9776
Mailing Address - Fax:
Practice Address - Street 1:616 PETOSKEY ST STE 403
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2700
Practice Address - Country:US
Practice Address - Phone:231-714-9776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty