Solara Integrative Therapy LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOLARA INTEGRATIVE THERAPY LLC

Practice address

2100 Egret Cir
Evans, GA 30809-4356

Phone

(706) 951-7644

NPI assigned

Nov 18, 2024

Last updated

Nov 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Keith W. Edmonds, ED.D., LPCNPI 1073844395

Title

Owner

Phone

(706) 951-7644

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keith Wilson Edmonds, LPC

  • Professional Counselor
  • Evans, GA
  • NPI 1073844395
  NPD Authorized official

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1467277244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 EGRET CIR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094356",
            "telephone_number": "706-951-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 EGRET CIR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094356",
            "telephone_number": "706-951-7644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLARA INTEGRATIVE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "EDMONDS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-951-7644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "ED.D., LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanne Elaine Smith, PHARM D
• Sade Smith
• Stanley T Smith Jr., M.D.
• Stephen Michael Smith, RN, SRNA
• SNH Georgia Tenant LLC (Morningside of Evans)
• Victor Alejandro Soto Velazquez
• Kevin Scott Soto, PT
• Southeast Surgical Assistants, LLC
• Southeastern Aesthetic Surgery, LLC
• Southeastern Medical Brokers, Inc. (Integrity Medical)

• Professional Counselor in Evans, GA
• Providers in Evans, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.