Provider Demographics
NPI:1912989906
Name:SOLOMON, ELDON R (LMHC, MS)
Entity Type:Individual
Prefix:MR
First Name:ELDON
Middle Name:R
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:LMHC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N TILLOTSON AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-3988
Mailing Address - Country:US
Mailing Address - Phone:765-288-1928
Mailing Address - Fax:765-741-0335
Practice Address - Street 1:240 N TILLOTSON AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-3988
Practice Address - Country:US
Practice Address - Phone:765-288-1928
Practice Address - Fax:765-741-0335
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39000239A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000321933OtherBC/BS #
IN300356029OtherCIGNA
IN300356029OtherVALUE OPTIONS
IN000000492161OtherBCBS
IN300356029OtherCHOICE CARE
IN300356029OtherTRICARE
IN300356029OtherSAGAMORE
IN300356029OtherHORIZON BEHAVIORAL HEALTH
IN300356029OtherMAGELLAN