Provider Demographics
NPI:1912673799
Name:SOLSTICE MENTAL HEALTH, A LICENSED CLINICAL SOCIAL WORKER PC
Entity Type:Organization
Organization Name:SOLSTICE MENTAL HEALTH, A LICENSED CLINICAL SOCIAL WORKER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARING
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-953-8395
Mailing Address - Street 1:7190 W SUNSET BLVD # 40F
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-4415
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4730 N SACRAMENTO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-4306
Practice Address - Country:US
Practice Address - Phone:424-284-9325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty