Provider Demographics
NPI:1659194900
Name:SOLPATH FAMILY COUNSELING & WELLNESS CORP
Entity type:Organization
Organization Name:SOLPATH FAMILY COUNSELING & WELLNESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:619-567-9353
Mailing Address - Street 1:3500 FIFTH AVE APT 310G
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-5096
Mailing Address - Country:US
Mailing Address - Phone:619-567-9353
Mailing Address - Fax:
Practice Address - Street 1:3500 FIFTH AVE APT 310G
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-5096
Practice Address - Country:US
Practice Address - Phone:619-567-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty