Active NPI
Sololeya Teklehaimanot, LCSW
- Clinical Social Worker
- Champaign, IL
National Provider Identifier
1770265977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149041072
- Practice address
- 206 N Randolph St Ste 2
Champaign, IL 61820-3976 - Phone
- (833) 351-8255
- NPI assigned
- Aug 7, 2023
- Last updated
- Sep 16, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801120911 | MI | |
| Clinical Social Worker | 1041C0700X | TPSW7212 | FL | |
| Clinical Social Worker | 1041C0700X | 149041072 | IL | Primary |
Addresses
Primary practice location
206 N Randolph St Ste 2
Champaign, IL 61820-3976
Mailing address
PO Box 24449
New York, NY 10087-0589
Phone (833) 351-8255
Other practice location 1
4200 Fashion Square Blvd Ste 201
Saginaw, MI 48603-1375
Phone (833) 351-8255
Other practice location 2
3292 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 365-8920
Other practice location 3
101 N Monroe St Ste 800
Tallahassee, FL 32301-1549
Phone (833) 351-8255
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851116345 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1770265977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24449",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100870589",
"telephone_number": "833-351-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 N RANDOLPH ST STE 2",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618203976",
"telephone_number": "833-351-8255"
}
],
"practiceLocations": [
{
"address_1": "4200 Fashion Square Blvd Ste 201",
"address_purpose": "LOCATION",
"city": "Saginaw",
"state": "MI",
"postal_code": "486031375",
"country_code": "US",
"telephone_number": "833-351-8255",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3292 N Evergreen Dr NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495259746",
"country_code": "US",
"telephone_number": "616-365-8920",
"fax_number": "616-365-8971",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "101 N Monroe St Ste 800",
"address_purpose": "LOCATION",
"city": "Tallahassee",
"state": "FL",
"postal_code": "323011549",
"country_code": "US",
"telephone_number": "833-351-8255",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TEKLEHAIMANOT",
"first_name": "SOLOLEYA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-07",
"last_updated": "2026-09-16",
"certification_date": "2026-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801120911",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "TPSW7212",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149041072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.