Provider Demographics
NPI:1952996373
Name:SALUBRIOUS THERAPY SOLUTIONS LLC
Entity Type:Organization
Organization Name:SALUBRIOUS THERAPY SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:T. NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MAC
Authorized Official - Phone:757-593-1840
Mailing Address - Street 1:780 PILOT HOUSE DR STE 100A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4411
Mailing Address - Country:US
Mailing Address - Phone:757-593-1840
Mailing Address - Fax:
Practice Address - Street 1:780 PILOT HOUSE DR STE 100A
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4411
Practice Address - Country:US
Practice Address - Phone:757-593-1840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-08
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty