Provider Demographics
NPI:1881156073
Name:SOLOMON, ADRIAN DEWAYNE (LCSW; BSSW, MHRT-CRP)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:DEWAYNE
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:LCSW; BSSW, MHRT-CRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W FOWLKES ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3534
Mailing Address - Country:US
Mailing Address - Phone:901-378-1615
Mailing Address - Fax:
Practice Address - Street 1:138 W FOWLKES ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3534
Practice Address - Country:US
Practice Address - Phone:865-390-1403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
TNFP81801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN126752687Medicaid