Individual provider Active NPI

Carmilla Solomon, EDD LMHC

  • Mental Health Counselor
  • University Place, WA
National Provider Identifier
1316475882
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH60761434 Issued in WA
Practice address
3800 Bridgeport Way W Ste A290
University Place, WA 98466-4495
Phone
(321) 890-5523
NPI assigned
May 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH14844 FL
Mental Health Counselor 101YM0800X LH60761434 WA Primary

Addresses

Primary practice location

3800 Bridgeport Way W Ste A290
University Place, WA 98466-4495

Mailing address

3800 Bridgeport Way W Ste A290
University Place, WA 98466-4495
Phone (321) 890-5523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH14844FLMDMental Health Counselor
LH60761434WAMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1316475882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 BRIDGEPORT WAY W STE A290",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664495",
            "telephone_number": "321-890-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 BRIDGEPORT WAY W STE A290",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664495",
            "telephone_number": "321-890-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "CARMILLA",
        "name_prefix": "Dr.",
        "credential": "EDD LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH14844",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60761434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.